Differential Diagnosis for Progressive Memory Impairment, Personality Changes, and Hyperactivity in a 70-Year-Old Male
Single Most Likely Diagnosis
- Alzheimer's Disease: The most common cause of dementia, characterized by progressive memory impairment, and can also lead to personality changes and altered behavior, including hyperactivity in some cases.
Other Likely Diagnoses
- Frontotemporal Dementia: A group of diseases characterized by the progressive degeneration of the frontal and temporal lobes, leading to significant changes in personality, behavior, and eventually memory.
- Vascular Dementia: The second most common cause of dementia, resulting from reduced blood flow to the brain, which can cause memory impairments, personality changes, and other cognitive deficits.
- Lewy Body Dementia: Characterized by the presence of Lewy bodies in the brain, leading to cognitive decline, hallucinations, and fluctuations in alertness and attention, which could be mistaken for hyperactivity.
Do Not Miss Diagnoses
- Chronic Subdural Hematoma: A condition where blood collects on the brain's surface, often due to minor trauma, which can cause cognitive decline, personality changes, and altered mental status, including hyperactivity.
- Normal Pressure Hydrocephalus (NPH): A condition characterized by the accumulation of cerebrospinal fluid in the brain's ventricles, leading to increased pressure, which can cause dementia, gait disturbances, and urinary incontinence.
- Hypothyroidism: Severe, untreated hypothyroidism can lead to cognitive impairments, personality changes, and in rare cases, hyperactivity or agitation.
- Vitamin B12 Deficiency: A deficiency in vitamin B12 can cause neurological symptoms, including cognitive decline, personality changes, and in some cases, hyperactivity or restlessness.
Rare Diagnoses
- Creutzfeldt-Jakob Disease: A rare, degenerative, fatal brain disorder caused by an abnormal form of a protein called a prion, leading to 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, including personality changes and hyperactivity.
- Prion Diseases (other than Creutzfeldt-Jakob Disease): Other prion diseases, such as Gerstmann-Sträussler-Scheinker disease or fatal familial insomnia, are extremely rare and can present with cognitive decline, personality changes, and altered behavior.