Differential Diagnosis
- Single most likely diagnosis
- Alzheimer's disease: The patient's symptoms, such as recall of 2/3, doing everything by herself but forgetting why she went out, and forgetting names, are consistent with early-stage Alzheimer's disease. These symptoms suggest a decline in cognitive function, particularly in memory and executive function, which are hallmark features of Alzheimer's.
- Other Likely diagnoses
- Vascular dementia: This condition can also present with memory loss and cognitive decline, although it often has a more step-wise progression and may be accompanied by other symptoms such as focal neurological deficits.
- Frontotemporal dementia: While less common, frontotemporal dementia can present with significant changes in personality, behavior, and language, in addition to memory impairments.
- Normal Pressure Hydrocephalus (NPH): NPH can cause cognitive decline, gait disturbances, and urinary incontinence, but the cognitive symptoms can sometimes mimic those of Alzheimer's or other dementias.
- Do Not Miss diagnoses
- Vitamin B12 deficiency: A deficiency in vitamin B12 can cause neurological symptoms including cognitive decline, which can mimic dementia. It's crucial to diagnose and treat this condition as it is reversible.
- Thyroid dysfunction: Both hypothyroidism and hyperthyroidism can cause cognitive symptoms that may be mistaken for dementia. These conditions are treatable and should not be overlooked.
- Chronic subdural hematoma: Especially in the elderly, a chronic subdural hematoma can present with gradual cognitive decline and should be considered due to its potential for serious consequences if not treated.
- Rare diagnoses
- Creutzfeldt-Jakob disease: A rare, degenerative, fatal brain disorder that can cause rapid cognitive decline, memory loss, and personality changes.
- Huntington's disease: An inherited disorder that causes brain cells to die, leading to cognitive decline, motor dysfunction, and psychiatric problems. It's less likely given the description but should be considered in younger patients or those with a family history.
- Wilson's disease: A genetic disorder that leads to copper accumulation in the brain and liver, causing neurological symptoms, including cognitive decline, but it typically presents at a younger age.