question: Q:A 68-year-old man seeks evaluation by a physician with complaints of worsening forgetfulness and confusion for 1 year. According to his wife, he has always been in good health and is generally very happy; however, he has started to forget important things. He recently had his driving license revoked because of multiple tickets, but he cannot recall having done anything wrong. This morning, he neglected to put on his socks and was quite agitated when she pointed this out to him. He denies having a depressed mood, sleep problems, or loss of interest. He occasionally has a glass of wine with dinner and has never smoked or used recreational drugs. His medical history and family medical history are unremarkable. His pulse is 68/min, respirations are 14/min, and blood pressure is 130/84 mm Hg. Except for a mini-mental state examination (MMSE) score of 20/30, the remainder of the physical examination is unremarkable. Imaging studies, including a chest X-ray and CT of the brain, reveal no pathologic findings. An electrocardiogram (ECG) is also normal. Laboratory testing showed the following:
  Serum glucose (fasting) 76 mg/dL
  Serum electrolytes:  
  Sodium 140 mEq/L
  Potassium 4.1 mEq/L
  Chloride 100 mEq/L
  Serum creatinine 0.9 mg/dL
  Blood urea nitrogen 11 mg/dL
  Cholesterol, total: 180 mg/dL
  HDL-cholesterol 45 mg/dL
  LDL-cholesterol 75 mg/dL
  Triglycerides 135 mg/dL
  Hemoglobin (Hb%) 16 g/dL
  Mean corpuscular volume (MCV)  85 fL
  Reticulocyte count 0.9%
  Erythrocyte count 5 million/mm³
  Thyroid-stimulating hormone 3.5 µU/mL
  Urinalysis 
  Glucose Negative
  Ketones Negative
  Leucocytes Negative
  Nitrite Negative
  RBCs Negative
  Casts Negative
  Which of the following is the most likely diagnosis?? 
  {'A': 'Alzheimer’s dementia', 'B': 'Creutzfeldt-Jakob disease', 'C': 'Lewy body dementia', 'D': 'Parkinson’s disease', 'E': 'Vascular dementia'},