A 69-year-old woman presents to the clinic with memory difficulty. The patient’s daughter is concerned that her mother is having difficulty doing her finances, such as paying bills. Memory impairment testing reveals the poor ability to generate lists of words or copy diagrams (intersecting pentagons). Her remaining physical examination is normal. Which of the following anatomic findings is most likely with her condition?
Correct Answer: diffuse atrophy of the cerebral cortex and temporal lobes
Description: Alzheimer disease (AD) can be quite diffuse, but there is particular involvement of the medial temporal lobes and cortical association areas. The atrophy of the hippocampus is particularly marked. Microscopic examination reveals neurofibrillary tangles and amyloid plaques. Hemiplegia is not a feature of AD and suggests more vascular disease and vascular dementia. The cranial nerves are not involved in AD.
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