A seventy-eight-year-old man is brought by his daughter for…
A seventy-eight-year-old man is brought by his daughter for concerns about his memory. Over the past 18 months, he has repeatedly missed bill payments, gotten lost driving to familiar places, and forgotten recent conversations. He still dresses, bathes, and feeds himself, but now needs help organizing his medications and finances. On examination, he is pleasant but has difficulty with short-term recall. His mini-mental state examination (MMSE) score is 22 out of 30. Depression screening is negative. Thyroid studies, vitamin B twelve (vitamin B12), and basic metabolic panel are normal. Computed tomography (CT) of the head shows only mild age-related atrophy. You diagnose probable mild Alzheimer’s type dementia. What is the most appropriate medication plan to discuss in primary care today?