Differential Diagnosis for a 58-year-old man with disturbed recent memory and behavioral changes

• Single most likely diagnosis
  • B. Alzheimer's Disease: This is the most common cause of dementia in older adults, characterized by a gradual decline in cognitive function, including recent memory loss, and often accompanied by behavioral changes. The age of the patient and the presentation of disturbed recent memory as a cardinal feature align closely with Alzheimer's Disease.
• Other Likely diagnoses
  • D. Multi-infarct dementia: This condition, also known as vascular dementia, is the second most common cause of dementia and can present with cognitive decline, including memory problems, and behavioral changes. It is caused by multiple small strokes and is more likely in patients with vascular risk factors.
  • C. Huntington's chorea: Although less common, Huntington's disease can present with cognitive decline, including memory disturbances, along with significant behavioral changes and motor symptoms like chorea. The age of onset can vary, but it typically starts in mid-life.
• Do Not Miss diagnoses
  • A. Multiple Sclerosis: While primarily known for its neurological symptoms such as optic neuritis, weakness, and coordination issues, multiple sclerosis can also have cognitive manifestations, including memory problems. However, it would be less likely to present primarily with disturbed recent memory and behavioral changes without other characteristic symptoms.
• Rare diagnoses
  • Other rare causes of dementia and cognitive decline, such as frontotemporal dementia, Lewy body dementia, Creutzfeldt-Jakob disease, and normal pressure hydrocephalus, could also be considered but are less likely given the information provided. These conditions often have distinctive features that might not be immediately apparent without further investigation.

Each of these diagnoses requires careful consideration of the patient's full clinical picture, including history, physical examination, laboratory tests, and sometimes imaging studies, to determine the most accurate diagnosis and appropriate management plan.