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Washington University Experience | NEURODEGENERATION | Hippocampal Sclerosis of Aging | 4A0 Case 4 History
Case 4 History ---- This female patient was first seen by the ADRC in July 2000 at the age of 86. Medical history at her initial visit was significant for history of CHF, chronic insomnia, and depression following an MVA in November 1999 which resulted in lengthy hospitalization and rehabilitation. In 2000 the ADRC clinician rated the patient CDR 0, no dementia. In 2004 she had moved to a retirement community with a new diagnosis of COPD but remained CDR 0, no dementia. Health changes in 2005 included cardiac stent placement following an MI. Her son, her collateral source (CS) noted consistent changes in his mother’s memory and function following her MI in 2005. In 2006 the clinician rated the patient CDR 0.5. In 2007 the CS reported a two-year history of consistent changes in memory and function. The clinician rated the patient CDR 0.5, dementia of the Alzheimer type with depression. The patient was last seen in May 2008 at the age of 94. New health concerns were Type 2 diabetes, anemia, and worsening COPD. The CS noted the patient had become increasingly frail and physical changes and fluctuation in oxygenation appeared to influence her cognitive ability. She required physical help for all activities of daily living (ADLs). She entered hospice in November 2008 with worsening respiratory status and died shortly thereafter at the age of 94 with a CDR of 1. The stated clinical cause of death was respiratory failure with dementia of the Alzheimer’s type contributing. ---- At autopsy the fresh brain weighed 1080g. --- Not shown (not available): There was mild atrophy of the frontal, temporal and parietal lobes. Coronal slicing revealed mild dilatation of the lateral ventricle with rounding of the angles, increased space in the inferior temporal horn, and a small hippocampus. There was no significant loss of pigment from either the substantia nigra or locus ceruleus.
