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Alzheimer disease — MCCQE Part 1 MCQ

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ModerateMemory LossAlzheimer diseaseMCCQE Part 1

74-year-old woman presents with gradual memory decline. She has impaired instrumental activities of daily living and normal TSH/B12. Which of the following is the most appropriate next step?

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Correct answer: E — Diagnose probable dementia after cognitive/functional assessment and discuss supports, safety and medications

Diagnose probable dementia after cognitive/functional assessment and discuss supports, safety and medications is best because progressive cognitive and functional decline supports dementia. Provide reassurance only and arrange no follow-up is suboptimal because mental health risk often requires structured follow-up or urgent escalation; Use long-term benzodiazepine monotherapy as default treatment is suboptimal because benzodiazepine monotherapy is rarely an appropriate long-term strategy; Avoid direct risk assessment to preserve rapport is suboptimal because direct assessment of suicide, violence, capacity and substance use is clinically appropriate; Attribute symptoms to personality or culture without assessing illness is suboptimal because diagnostic overshadowing risks missing treatable mental illness. Driving, medication management and caregiver support are part of care.

Reference: Canadian Consensus Conference on Diagnosis and Treatment of Dementia