Janet Riley is a 79-year-old Caucasian who has progressive cognitive and memory deficits and showed behavioral changes over the past year. The woman is quite difficult to assess and does not answer many questions. She managed to give answers to some of the questions; however, the majority of them remained unanswered. These symptoms can be signs of various diseases; hence, the patient would be asked to make some tests, provide the physician with her medical history, and create or describe her problem list. Based on the conducted tests, the doctor would define which illness provoked the described cognitive and memory difficulties; therefore, the appropriate treatment would be prescribed.
After reviewing the results of the history, exam, and problem list, I would expect to see several tests for Janet Riley. The human brain controls the majority of cognitive functions and relates to people’s ability to understand and store information. In this case, progressive cognitive and memory problems are present; therefore, I would advise running several brain-tests first. A magnetic resonance imaging (MRI), Positron Emission Tomography (PET), and a computer tomography (CT) scan would be useful for understanding brain degeneration and the corresponding functional and anatomical information (Ahmed et al., 2019). In addition, these brain scans would depict the functioning of the patient’s brain and represent the existing difficulties or misconducts. Moreover, I would ask the patient to take a blood test to check the level of blood sugar, do the overall medical check-up, and exclude diverse infections that could affect both the brain and the body. Additionally, this analysis helps the physician understand the thickness of blood and conclude whether the patient is predisposed to blood clots and thrombus or not.
After the described procedures, I would advise the patient to consult a neurologist and a psychiatrist to estimate the individual’s mental state from the perspectives of psychology and neurology. The psychologist would help define whether cognitive and mental deficits may be caused by a psychologically traumatic experience or diverse social effects, for example. At the same time, the neurologist would check the patient’s nerves, nervous system, and reflexes to conclude whether the problem lies in these spheres of medicine or not. In addition, the mentioned specialists could support the doctor in diagnosing general illnesses of aging people such as dementia or sclerosis. Sometimes, cancer can produce the described effects due to the paraneoplastic syndrome; hence, the blood tests would give the doctor an understanding of the existence of a tumor.
Based on the conducted tests, problem list, illness history, and examinations, such diseases as dementia, sclerosis, Alzheimer’s illness, cancer, myocardial infarction, or Parkinson’s disease can be the reason. According to the shown symptoms and test results, Janet Riley is likely to have Alzheimer’s illness, which is also one of the forms of dementia. In addition, Alzheimer’s disease (AD) is one of the most common forms of dementia shown by elderly people (Joe & Ringman, 2019). At this point, the symptoms are rather evident; therefore, it might be the period of the transformation of the light form into a severe form of AD.
The latest phase of the disease can be described as the full loss of basic cognitive skills; hence, the patients need to be fed. In addition, urinary and fecal incontinence is often an evident characteristic of the late phase. The patients lose the ability to express themselves and consciously analyze information, they lack stable locomotion, and diverse neurological problems become apparent. However, Janet Riley’s symptoms are not that deep, but they are too evident for the early phase; hence, I would state that she is in the process of transfer between the stages. People with Alzheimer’s disease are generally heavily affected by such illnesses as pneumonia or sepsis because of failure in their immunity system and the fatigued body condition.
Although the disease cannot be reduced, it can be stopped in its development. For example, intensive intellectual training is one of the non-drug possible treatments. Neuropsychological rehabilitation can help stimulate nerve cells to create new neuronal connections. Special medicine can also help lower the progress in the illness and provide symptomatic relief (Arvanitakis et al., 2019). Despite the existence of such methods, they do not always help patients and do not tend to be highly effective. This disease is not well-researched; therefore, innovational methods of its curing have not been discovered yet.
I managed to arrive at Janet Riley’s problem list by asking several simple questions that she was able to answer. However, I did not get all the wanted information; hence our dialogue is quite short:
- Do you know where you are?
- At the hospital.
- Why are you here?
- I do not know.
- Can you name some of your relatives? What is your daughter’s name?
- I do not remember.
- What is your mother’s name?
The patient did not give an answer to the last question. In addition, the woman tended to mumble and speak unclearly, sometimes it was difficult to understand the pronounced words. Based on this assessment, I supposed that it could be dementia or an unrecognized myocardial infarction that damaged the main brain functions. However, lab tests, such as the MRI, CT, and the consultation of the neurologist, helped me understand that it was AD. The disease is difficult to recognize, but the doctors managed to notice it and provide the appropriate treatment.
References
Ahmed, M. R., Zhang, Y., Feng, Z., Lo, B., Inan, O. T., & Liao, H. (2019). Neuroimaging and machine learning for dementia diagnosis: Recent advancements and future prospects. IEEE Reviews in Biomedical Engineering, 12, 19-33. Web.
Arvanitakis, Z., Shah, R. C., & Bennet, D. A. (2019). Diagnosis and management of dementia: Review. JAMA, 322(16), 1589-1599. Web.
Joe, E., & Ringman, J. M. (2019). Cognitive symptoms of Alzheimer’s disease: Clinical management and prevention. BMJ, 376, 1-14. Web.