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A 72-year-old woman is brought to the office by her son for evaluation of gradually progressive forgetfulness over the past 18 months. On a recent week-long visit, she could not learn the name of the hosts' dog. She frequently re-reads the daily paper, and tends to ask the same questions repeatedly. She has no significant medical history and no abnormalities of gait, posture, coordination, speech, or dexterity. Personality is preserved. On examination, vital signs are normal, as is attention. Her score on Mini“Mental State Examination is 21/30, and she recalls 0/3 words after brief distraction. She has difficulty copying a geometric figure. Neurologic examination is otherwise normal.

Which of the following is the most likely diagnosis?

A Alzheimer's dementia
B Frontotemporal dementia
C Dementia with Lewy bodies
D Vascular dementia
E Dementia secondary to vitamin B12 deficiency

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¢Alzheimer's disease is characterized by primary dementia with prominent amnesia.
¢Dementia with Lewy bodies, fluctuating cognition, parkinsonism, and/or visual hallucinations, often coexists with Alzheimer's disease.

hypothyroidism or vitamin B12 deficiency, usually cause attentional impairment and slowing of thought, and rarely mimic the amnesic profile of Alzheimer's dementia.
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