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Washington University Experience | NEURODEGENERATION | Alzheimer Disease | Gross Pathology | 11A0 Case 11 History
Case 11 History ---- The patient was first seen in August 1980 when she was 72 years old. She had a 5-6 year history of increasing memory problems, with examples given such as forgetting how to cook certain types of meals and becoming lost while driving. Recent memory was reported to be worse than past memory, and this process was gradually progressive without major changes in personality noted. The symptoms interfered with her work as well as with volunteer groups. There was no evidence of aphasia or major depression. Her CDR was 1. In April 1982 she exhibited continued deterioration, especially of recent recall. Over the next year, increasing difficulties with aphasia developed. CDRs varied between 2-3. Her behavior became more difficult to manage and incontinence became a frequent occurrence. In November 1985 it was reported that in July and August of that year she had two seizures and was being treated with Dilantin. She was placed in a nursing home in September 1985, and her memory was reported to be gone completely. During the December 1986 assessment in the nursing home, she apparently did not recognize anyone; at times she required restraints; she picked imaginary spots off the floors; she had fallen several times and had become very passive. Her CDR at this time was 3. In February 1988, she could no longer feed herself; her weight had dropped from 140 to 98 pounds. She continued at CDR-3 until her death in June 1994. She had been treated at an OSH in January 1994 for decubiti which were positive for Methicillin resistant Staphylococcus aureus. Prior to her demise her temperature spiked at 99 F and she was noted to have coffee ground emesis. Because of her debilitated status, she was not treated with antibiotics. She had become increasingly obtunded and was found dead in June 1994 in the nursing home. In summary, the patient’s symptoms started at approximately age 66 and gradually and continuously progressed to CDR-3. She died at the age of 86.
