A 78-year-old female comes to the clinic for a physical examination. She is accompanied by her daughter and looks to her daughter to answer questions during the interview
She was diagnosed with early Alzheimer's disease 2 years ago, and her daughter would like her current mental status evaluated.
You ask the patient her daughter's name, and she answers correctly. You ask her the date and time, and she answers incorrectly. You hand the patient a pencil and ask her if she knows what it is. She replies with, "Is it a stick?" You ask the patient to put on a patient gown, and she does not know how to perform the task. These are examples of disorientation to time and:
A. Agnosia and apraxia
B. Anomia and aphasia
C. Agnosia and ataxia
D. Apathy and ataxia
ANS: A
Most organic dementias develop over months to years. There are typically no physical motor or sensory alterations until the condition is advanced. Memory impairment is the predominant symptom. There may be impairment in another area of cognitive functioning, such as with aphasia (producing language as well as understanding it), agnosia (perceptual impairment of environment), apraxia (inability to perform complex motor acts), and impairment in executive functioning (inability to plan, organize, sequence, and think abstractly). Ataxia is not a symptom of dementia—it is a problem with gait usually due to cerebellar dysfunction.
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