A 74 year old man accompanied by his worried wife with conce…
A 74 year old man accompanied by his worried wife with concerns for possible dementia is seen in the office. He retired from his work as a family practice physician four months ago and his wife notes decline in his memory and cognitive functioning since that time. He seemed sharp and his practice was going well when he retired. In the appointment, the patient was unkempt and unshaved. He looked at the floor much of the time and answered most questions slowly with “I don’t know” if he responded at all. No confabulation or response to internal stimuli was observed. He typically stays in bed much of the day reading or sleeping and has lost weight. Inattentiveness and forgetfulness are assessed during the MSE. The best treatment recommendation is __________________ with a two week follow up appointment.