Neurologic System & Mental Health: Case Study Discussion

Read the case study below and answer the questions provided.  Comment on 2 of your peers’ submissions.

A 73-year-old woman is brought to your clinic by her husband for a chief complaint of "worsening memory loss." She is a retired teacher who has recently been getting lost in her own subdivision. She has lived in the same house for 30 years.  Neighbors have brought her back home on several occasions. When questioned, she becomes visibly upset and reports that she was only "trying to exercise." Her husband reports that she has also had increasing difficulty managing her finances and has overdrawn her checking account on several occasions. A physical examination was performed and was normal except that she scored 12 points out of 30 on the Mini-Mental State Examination. Work-up was ordered to assess for causes of confusion.  A CT scan was ordered and revealed generalized brain atrophy, but this was possibly within normal parameters expected for her age. She is diagnosed with dementia, likely from Alzheimer’s disease.

Questions:

• What are some alternate causes for confusion that would have been ruled out?
• Where in the brain are neuritic plaques most prominent in Alzheimer’s disease and how does that explain the patient’s symptoms?
• What role does amyloid beta-peptide, the major protein in neuritic plaques, play in Alzheimer’s disease?
• Would you recommend genetic testing to determine risk for developing Alzheimer’s disease to the patient’s children?  Why or why not?
• Search for a peer-reviewed article regarding Alzheimer’s disease and discuss the findings of the articles with your peers.

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