ABSTRACT
Mrs Jones is a 73-year-old woman who used to be a teacher and lives alone following the death of her husband a year ago. Her daughter accompanies her at a medical appointment. Mrs Jones’ score on the MiniMental State Examination (MMSE) is 26/30. She can undertake the main activities of daily living independently (bathing and dressing, preparing meals, using the telephone, doing housework and taking medication). During the interview, Mrs Jones is alert, cooperative, answers the questions asked and has no word-finding difficulties on conversation. Although she acknowledges difficulty in recalling new events, orienting herself in unfamiliar places and finding appropriate words, she argues that this is just normal for her age. Her daughter has noticed a gradual decline of her cognitive capacities, including forgetfulness (recent conversations, appointments), occasional writing errors and a tendency to jot down notes. In spite of the fact that the patient has always managed her finances in the past, the daughter now has to oversee her mother’s financial transactions. Moreover, she reports that her mother is more disorganized and anxious whenever her routine is disrupted. This was particularly obvious on a recent occasion when her children invited her to a restaurant. She lost track of the conversation, repeated herself and was less aware than before of recent public events, although she reported reading the newspaper on a daily basis. In light of the elements described here, the practitioner requested a neuropsychological assessment.
