Problem:
A 69-year-old woman was referred for a workup due to concern about dementia. Her family indicated that there has been gradual memory decline for the past four years. Now, the patient quickly forgets conversations, she misplaces items which results in her thinking that other people must have moved or taken the items, she occasionally forgets to go to doctor appointments, and she has gotten lost while driving her car in a familiar location. The patient's family also reported that the patient's memory for long-term information seems a bit fuzzy. For example, it was stated that the patient remembers vacations from the past, but when talking about them, she seems to mix up details from various vacations. The patient is not particularly concerned about her difficulties and she is not all that interested in treating her memory decline. Her family, however, is quite concerned.
Her Mini-Mental Status Examination score is 19. The family would like the patient treated and are questing a medication that could reverse the memory loss. You explain that all current medications are to prevent further decline in memory but do not reverse current state. Discuss one pharmacological option, including dosing, benefits vs. risks, side effects, etc. Discuss non-pharmacological options for prevention of further deterioration, as well as recommendations for the patient's children to reduce risk of dementia.