Case Mystery #1
Rose Smith, a 78-year-old African-American woman, was brought to the clinic for evaluation by her daughter because of a 3-year
history of memory impairment. She worked as an administrative assistant at a local community college until her retirement in 2006.
She had lived alone and maintained her own home and financial affairs since the death of her husband in 2010. Her daughter had
noticed gradually worsening memory impairment and difficulty finding words, but the patient became angry at the suggestion that she
may have a progressive impairment. Others had noted decline in housekeeping and financial affairs, and that she no longer attended
neighborhood socials. At the encouragement of her daughter, she decided to move in with her daughter's family in 2017. The
daughter notes that during the last couple of years, her mother has gotten lost on short neighborhood walks on two occasions and
seems to have trouble remembering her grandchildren.
Her speech was highly anomic and paraphasia, with a tendency to use vague referents such as "things" and "stuff". She was able to
provide her name, but when asked about her current age, she said: "I don't know . . ., about 8 I think." She incorrectly stated her birth
month, but then became aware of this. Given three choices, she was able to give the correct month. She was unable to give the year of
her birth, the current year, or the name of the current U.S. President. On formal testing, she scored well below average in all cognitive
domains. She tended to perseverate both verbal and motor responses.
1. Probable patient diagnosis
2. Rationale for the diagnosis citing factors from the case
3. The relationship between the pathophysiology of this disorder and the patient manifestations.
