The patient lives at home, but over time has required increased and now full-time supervision. On exam, as before, he has flat affect but becomes anxious when questioned. He is unable to answer many simple questions, and his short-term memory is poor. He makes mild aphasic errors. He has a palmomental reflex.
Neurologic exam is otherwise unremarkable.
Cerebral cortical neurofibrillary tangles and senile plaques, impaired synaptic function, and cell loss. Prominent loss of cholinergic, noradrenergic, and dopaminergic neurons. Antioxidants Proposed neuroprotection by reduction of oxidant stress. Selegiline-monoamine oxidase inhibitor that inhibits oxidative deamination and also facilitates catecholamine activity. In Alzheimer's dementia, short-term trials of selegiline have shown significant benefit in cognition.