A 68-year-old male is brought to see his primary care provid…
A 68-year-old male is brought to see his primary care provider by his daughter who is concerned about him. According to his daughter, the patient experienced the death of his wife six months ago and since then has had a “major decline” in his ability to function. His daughter now feels the need to stop by his house at least once per day to ensure that they are meals available for him to eat “or else he will probably just starve.” He scores a 14/30 on the MoCA, with points lost primarily for several tasks which he declined to attempt (“That sounds like a lot of work. What’s the point of all this? I want to go home.”). When asked about his memory, he says, “Yeah, I forget things all the time. Phone numbers, names, dates – they’re all gone.” He reports difficulty sleeping at night and says that sometimes he hears the voice of his wife “calling out my name.” Which of the following most strongly argues against a diagnosis of Alzheimer’s disease for this patient?
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