Instructions: Attempt the Step 3 question(s) below, pick one answer from the options below and then get the answer by clicking on get answer button.
Question
A 74-year-old man who lives with his sister is brought to the clinic because of behavioural changes and increasing “forgetfulness” over the past year. He often forgets to lock the bathroom door or to change his underwear after he takes a shower. He does some things twice because he has forgotten that he has already done them. Sometimes he accuses his nephew of stealing his money because he cannot find his wallet. He wanted to come to the doctor because he wanted to prove that he was “fine”. He has no history of major medical problems in the past. Mini-Mental Status examination reveals cognitive deficits with the Folstein score of 21. Additional testing is ordered and findings indicate that diagnosis of dementia of Alzheimer type. He is brought back to the clinic for reevaluation and discussion. His Folstein score on this visit is 20. Further steps are discussed in a family meeting with the patient and his family. Given the present clinical picture of dementia, Alzheimer type, the most appropriate next step in management is to
A. Admit him to the geriatric psychiatry unit
B. Begin a trial of donepezil and keep the patient at home
C. Reassure the family that the addition of vitamins B and E will be sufficient to control the symptoms
D. Recommend a brain biopsy
E. Recommend a residential facility with close supervision
