A 67-year-old man comes to the clinic for the first time. He s | Obstetrics & Gynecology

A 67-year-old man comes to the clinic for the first time. He speaks and walks very slowly. The patient's chief symptom is "extreme forgetfulness" for the past 6 months and he fears he is developing "dementia like my father." He says, "I used to be a very bright and sharp person, but now I can't even concentrate to work or read a book or newspaper. I feel extremely low and useless." The patient tearfully shares that he has been losing sleep, has little energy, and recently took a leave of absence from work as he could no longer concentrate on details and complete his paperwork. Medical history is significant for hypertension, hypercholesterolemia, diabetes, benign prostatic hyperplasia, and transient ischemic attack. Family history is significant for hypertension and diabetes in his mother and Alzheimer disease in his father. He does not smoke and drinks wine only occasionally. The patient has lived alone for the last 6 months since his son moved out Physical examination is normal except for markedly slow movements. CT scan of the head is normal.