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thank you 2011-02-06 23:26:21 GMT 2011-02-08 00:00:00 (GMT -05:00) Eastern Time (US & Canada) Yes (click here to learn more about ) Closed 0 0 3 direct invitation(s) have been sent by the voice seeker resulting in 0 audition(s) and/or proposal(s) so far. Voice123 SmartCast is seeking 10 auditions and/or proposals for this project (approx.) Invitations sent by SmartCast have resulted in 0 audition(s) and/or proposal(s) so far.
When an older patient comes to me with cognitive symptoms, it’s always concerning. The first question they usually ask is—Do I have Alzheimer’s?
It’s perfectly normal to forget things from time to time—we’ve all done it—but combined with Dan’s personality changes, there’s definitely reason for concern. So I asked Dan some more questions about the types of problems he’s been experiencing. A lot of times patients are reluctant to admit that something is wrong, so it’s good that Betsy is here with him.
Dan admitted that he does misplace items more than usual, and confesses that he got confused driving to his weekly card game last week.
I reviewed his medications. He’s been taking the same medications for the last several years—a beta-blocker for his high blood pressure and a statin for his cholesterol.
When I asked Dan if there was any family history of Alzheimer’s or other dementias, he said that he thinks an aunt and uncle both had it.
I performed a physical exam, focusing on Dan’s cardiovascular system. I listened to his carotid arteries and noted that they are clear. I also performed a neurological exam to look for signs of stroke or other neurological problems. Dan’s reflexes are normal and there is no evidence of weakness on either side of his body.
In cases of suspected Alzheimer’s, I usually do a mini-cog test. I gave Dan three words to remember: “Jacket, horseshoe, and lark,” and asked him to repeat them back to me and remember them for later.
The results of Dan’s cognitive testing indicate that he has probable Alzheimer’s—based on my experience with other Alzheimer’s patients, I would say it’s almost definite. At this time, I consider him to have mild Alzheimer’s. Based on his symptoms, I’d say that he probably has been experiencing a gradual decline in cognition and memory for awhile, and hasn’t noticed it.
I explain to Dan and Betsy that our available treatment options cannot stop his Alzheimer’s from progressing, but may be able to help his symptoms for awhile.
I gave him a prescription for a cholinesterase inhibitor and instructed him to take it daily from now on. I asked Betsy to help him set up an easy way to remember to take his pills. I also recommended that Dan take a DHA supplement.
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