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Washington University Experience | NEURODEGENERATION | Lewy Body Disease (LBD) | 6 LBD - Microscopic Pathology - Cerebral Cortex | 4A0 Case 4 History
Case 4 History ---- This 74yo male was seen at the Memory Diagnostic Center (MDC) in January 2001 with a 25 year history of excessive alcohol use. The Collateral Sources (CS), his daughter and son, reported a very gradual progression of cognitive change over three years. There was an episode of getting disoriented and lost in his own neighborhood. He was having difficulty with financial decisions and accounts. Psychometric testing showed consistent deficits in episodic memory and executive function. The clinician rated him CDR 0.5, DAT with alcoholism believed to contribute importantly to his dementia. MRI of the brain showed nonspecific white matter disease. Aricept was initiated. In August 2003, he stopped drinking and, by his July 2004 MDC visit, he had stopped driving because his license was revoked. During a European trip in June 2004, he had an episode of psychosis/irritability and was hospitalized on his return home. He was treated with Seroquel. His MMSE at this visit was 25 and CDR was 0.5. He was hospitalized in August 2004 for increased confusion and dysarthria. By February 2005, there was a daily hired caregiver in his home. Later that month, he was admitted to the gerento-psychiatric ward for a month for medication adjustment and he was discharged on heavy doses of psychoactive drugs. In March 2005, he was hospitalized with aspiration pneumonia and placed on a respirator plus a feeding tube. Upon discharge, he entered a nursing home. In late 2005, he fell out of bed fracturing a hip which required hip replacement surgery. He died in January 2009 at age 81 of end-stage dementia and GI bleeding at a CDR stage 3
