Imagine Not Being Able To Form New Memories This Is The Real ✓ Solved

Imagine Not Being Able To Form New Memories This Is The Reality Patie

Consider a case involving a 70-year-old female presenting with progressive forgetfulness over the past year. She reports occasional memory lapses, such as forgetting her intended actions when moving between rooms. Her family confirms these concerns but notes she remains capable of managing her finances and driving. The goal is to develop an Episodic/Focused SOAP note, including necessary patient history, physical exams, diagnostic tests, and a differential diagnosis with at least five potential conditions supported by literature.

Sample Paper For Above instruction

Subjective Data

Chief Complaint: Progressive forgetfulness over the past year.

History of Present Illness: The patient reports gradual worsening of memory, particularly with challenges recalling what she intended to do after moving to another room. She describes episodes of temporarily forgetting daily tasks but maintains independence in managing her finances and driving. There are no reports of confusion, disorientation, or changes in personality.

Past Medical History: Hypertension, hyperlipidemia, no history of neurological disorders.

Medication History: Amlodipine, atorvastatin.

Family History: Mother had dementia in her late 70s.

Social History: Lives alone, retired school teacher, supports active lifestyle.

Review of Systems: No reports of headaches, dizziness, visual disturbances, or other neurological symptoms.

Objective Data

Vital Signs: Blood pressure 130/80 mmHg, pulse 78 bpm, respirations 16, temperature 98.6°F.

Physical Examination: General physical exam unremarkable. Neurological exam shows normal cranial nerve function, intact motor and sensory systems, reflexes normal. Cognitive assessment reveals difficulty with short-term memory recall tasks but intact long-term memory.

Assessment

The patient's presentation suggests a neurocognitive disorder characterized by a decline in memory function, most consistent with age-related cognitive decline or early-stage dementia. Further diagnostic evaluation is warranted to differentiate among possible underlying causes.

Diagnostic Plan

  • Neuropsychological testing to quantify cognitive deficits.
  • Brain imaging: MRI to evaluate for atrophy, vascular lesions, or other structural anomalies.
  • Laboratory tests: CBC, metabolic panel, thyroid function tests, vitamin B12 levels, and syphilis serology.
  • Assessment of functional status to determine impact on daily living.

Differential Diagnosis

  1. Alzheimer’s Disease: Most common cause of progressive memory loss in elderly, characterized by cortical atrophy on imaging and amyloid plaques. Supported by evidence linking hippocampal atrophy with episodic memory deficits (Jack et al., 2018).
  2. Vascular Dementia: Result of cerebrovascular disease; associated with stepwise decline, vascular lesions on MRI, and risk factors like hypertension and hyperlipidemia (O'Brien & Thomas, 2015).
  3. Normal Aging: Mild forgetfulness typical in elderly, usually does not significantly impair daily functioning; distinguished from pathological decline (Harada et al., 2013).
  4. Medication Side Effects: Polypharmacy may contribute to cognitive impairment; review medications for sedatives, anticholinergics, or other CNS-active drugs (Campbell et al., 2014).
  5. Depression (Pseudodementia): Mood disorders can cause cognitive deficits mimicking dementia; screening with Geriatric Depression Scale recommended (Saczynski et al., 2020).

Conclusion

This case underscores the importance of comprehensive assessment in elderly patients presenting with memory complaints. Differentiating between causes like Alzheimer’s disease, vascular pathology, normal aging, medication effects, and depression is crucial for appropriate management. Early identification allows for targeted interventions that can improve quality of life.

References

  • Harada, C. N., Love, M. C., & Triebel, K. L. (2013). Normal cognitive aging. Clinics in Geriatric Medicine, 29(4), 737–752.
  • Jack, C. R., et al. (2018). NIA-AA research framework: Toward a biological definition of Alzheimer's disease. Alzheimer's & Dementia, 14(4), 535–562.
  • O'Brien, J. T., & Thomas, A. (2015). Vascular dementias. The Lancet, 386(10004), 1698–1706.
  • Saczynski, J. S., et al. (2020). Depression and dementia: A review of the biological links and clinical implications. Psychosomatics, 61(2), 157–172.
  • Campbell, N. L., et al. (2014). Medication and cognitive impairment in older adults. Journal of Geriatric Psychiatry and Neurology, 27(4), 237–245.
  • Orr, J. M., et al. (2014). Cognitive assessment in dementia. Neurologic Clinics, 32(2), 385–403.
  • Harada, C. N., et al. (2013). Normal cognitive aging: The role of structural and functional brain changes. Annual Review of Psychology, 64, 751–777.
  • Reisberg, B., et al. (2015). Clinical diagnosis of Alzheimer's disease: A practical approach. JAMA Neurology, 72(3), 305–312.
  • Prince, M., et al. (2015). Dementia Diagnosis, Treatment, and Care: A Review of the Literature. World Alzheimer Report.
  • Minett, T. (2017). Cognitive decline and management strategies. Journal of Clinical Neuroscience, 45, 10–15.

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