In an industry-funded, placebo-controlled trial of patients with early symptomatic Alzheimer disease and amyloid and tau pathology, patients on the investigational drug donanemab showed significant slowing in worsening on the integrated Alzheimer Disease Rating Scale score.
25 Jul 2023
An intervention with personalized risk-reduction goals, health coaching, and nurse visits was offered to patients who were between the ages of 70 and 89 years and had at least two targeted risk factors for dementia.
5 Dec 2023
An 82-year-old woman is seen for follow-up evaluation of Alzheimer disease. Since her last visit 12 weeks ago, she has been taking rivastigmine, with a progressively titrated dosage. The patient's only new symptoms are increasing insomnia, loss of appetite, and occasional diarrhea; she has had no feelings of hopelessness, helplessness, sadness, or guilt. Following a physical exam, Mini–Mental State Examination, and lab tests, what is the most appropriate next step in management?
7 Aug 2018
A 72-year-old man is evaluated for a 1-year history of progressively impaired gait and balance. He reports that he walks more slowly and is not as agile as he used to be, attributing a recently increased number of falls to not paying enough attention before tripping. In the past 6 months, he has had occasional problems recalling details of recent conversations and events, completing tasks around the house in a timely manner, and organizing and balancing his checkbook despite having been an accountant before retiring. Following a physical exam and MRI of the brain, what is the most appropriate next step in management?
1 Feb 2017
A 60-year-old man is evaluated for a 3-year history of gradual, progressive decline in his cognition, behavior, and motor skills. Following a physical exam, MRI, and neuropsychological testing, what is the most likely diagnosis?
28 Sep 2021
Because neurocognitive decline can have a variety of etiologies, a new definition by the DSM-5 defined mild cognitive impairment as a syndrome, and then drilled down to its etiology.
1 Jul 2019
A 53-year-old woman is brought to the office by her husband for follow-up evaluation of behavioral-variant frontotemporal dementia, which was diagnosed 9 months ago. Her clinical symptoms of occasional aphasia, minor memory impairment, behavioral disinhibition, and obsessive-compulsive behaviors have worsened since diagnosis and have become disruptive. Her husband asks about possible medications to control her symptoms. What is the most appropriate medication to recommend?
8 Jun 2021
A 60-year-old woman comes to the office to discuss the best strategy to prevent cognitive impairment. After a physical exam and cognitive screening testing, what is the most effective preventive measure?
16 Nov 2021
New guidelines and diagnostic advances are identifying Alzheimer's disease and its precursors much earlier in the course of the disease. The bad news is that, for now at least, these improvements may only create more dilemmas for general internists for the role of biomarkers and communicating with patients.
1 Sep 2011
If physical activity time is less than the guideline-recommended 150 minutes per week, clinicians should advise patients of the associated health benefits and encourage them to gradually increase either their frequency or duration of activity.
10 Apr 2018