Alzheimer Disease — Psychiatric Aspects

A 68-year-old woman is brought to the psychiatry outpatient clinic by her daughter with a 2-year history of progressive memory loss, difficulty finding words, and getting lost in familiar places. Over the past 6 months, the daughter reports increasing irritability, unprovoked anger outbursts, and refusal to bathe or change clothes. The patient denies sadness or suicidal ideation. Mini-Cog score is 2/3. MRI brain shows generalized cerebral atrophy with hippocampal shrinkage. Which of the following psychiatric symptoms is MOST characteristic of early-stage Alzheimer disease and would be expected in this patient?

A 72-year-old man with a 3-year history of Alzheimer disease is admitted to the psychiatric ward after his family reports a sudden onset of severe agitation, verbal aggression, and physical violence over the past 48 hours. He has no prior history of violence. His baseline cognitive function has been stable on donepezil. Vital signs: BP 142/88, HR 98, Temp 37.2°C, RR 20. Urinalysis shows nitrites and leukocyte esterase positive. His daughter mentions he has been refusing food and water. Which of the following is the MOST appropriate initial management?

A 68-year-old woman is brought to the psychiatry clinic by her daughter with a 2-year history of progressive memory loss, difficulty finding words, and getting lost in familiar places. Over the past 6 months, she has become increasingly suspicious of her family members, accusing them of stealing her belongings and hiding her money, despite no evidence. She also reports seeing her deceased husband in the living room at night, though she recognizes these visions are not real. Her Mini-Cog score is 2/3. MRI brain shows generalized cortical atrophy with hippocampal volume loss. Which psychiatric symptom in this patient is MOST consistent with the primary neurodegenerative process rather than a secondary behavioral disturbance?

In Alzheimer disease, which psychiatric symptom typically emerges EARLIEST in the disease course and is often the first complaint bringing patients to medical attention?

A 68-year-old woman is brought to the psychiatry outpatient clinic by her daughter with a 2-year history of progressive memory loss, difficulty finding words, and getting lost in familiar places. Over the past 6 months, the family reports increasing irritability, suspiciousness of family members, and occasional accusations that her husband is stealing from her. She has become withdrawn and no longer engages in social activities she previously enjoyed. On cognitive testing, she scores 18/30 on the Mini-Cog. Brain MRI shows global cerebral atrophy with prominent hippocampal shrinkage. Which of the following psychiatric symptoms in this patient is most consistent with the expected neuropsychiatric profile of Alzheimer disease?