A 76-year-old woman is brought to the family medicine clinic by her daughter because of 2 years of progressive short-term memory loss. She now struggles to manage her finances, has become lost while driving in her own neighbourhood, and needs prompting to bathe and dress. Her history includes hypertension and osteoarthritis, and her medications are amlodipine and acetaminophen. She has no known drug allergies, no history of peptic ulcer disease, syncope or asthma, and she does not drink alcohol. On examination she is alert and pleasant, with a regular pulse and no focal neurological deficits. Her Mini-Mental State Examination score is 16/30. Investigations including TSH, vitamin B12, calcium, creatinine (eGFR 68 mL/min/1.73 m2) and brain imaging show no reversible cause, and the findings are consistent with moderate Alzheimer dementia.
| Heart rate | 74/min |
| Respiratory rate | 14/min |
| Temperature | 36.8 °C |
| O2 saturation | 98%, room air |
| Blood pressure | 128/76 mm Hg |
Question 1 of 45
Which one of the following is the most appropriate initial pharmacotherapy for this patient's cognitive symptoms?
Select 1. (0 / 1 selected)
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