NBME Step 2 CK Form 8 Normal aging (NBME Answers)

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87 year old man who is independent in ADLs (eating, bathing, toileting, transferring, getting dressed) and iADLs (shopping, using phone, driving, handling finances, etc.), A&O x 3, recalls 2/3 objects after 5 minutes and has no focal neurologic findings most consistent with normal aging or mild cognitive impairment
Key idea: Patients with mild cognitive impairment will have mild decline in at least 1 cognitive domain, but will have normal functioning in all activities of daily living with compensation (taking a list to the store), whereas patients with dementia will have global cognitive impairment and marked functional impairment
To differentiate between Alzheimer’s and vascular dementia, look for other neurologic features (pronator drift, weakness, etc.) which is more consistent with vascular dementia

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kingfriday DDx: - Capgras syndrome: someone close to them or a loved one has been replaced by an imposter. Not what's going on here - Dimentia with Lewy Bodys -> would have hallucinations and features of parkinsonism also not seen here (mneumonic: ha-lewy-cinations) - Dimentia, Alzheimers type -> question stem would almost always mention something about the person getting lost in neighborhoods or unable to find their way as part of the pathology - MDD: doesn't meet the criteria of SIGECAPS - Metastatic prostate cancer -> typically presents with back pain which is not seen here Multi infart vascular dimentia -> often a stepwise decline (at 6 months x happened, then at 4 months y happened, and at 2 months z started happening) +1