Pair the following clinical presentations with the most likely corresponding neurocognitive disorder.
- A 67-year-old executive exhibits new-onset apathy, declining personal hygiene, and inappropriately sexually suggestive comments to staff, with relatively preserved memory and visuospatial skills.Behavioral variant frontotemporal dementia
- A 71-year-old mechanic develops recurrent, detailed visual hallucinations of animals, fluctuating periods of profound confusion, and a rigid, slow, shuffling gait.Dementia with Lewy bodies
- A 76-year-old retired nurse presents with a broad-based, magnetic gait, new-onset involuntary leakage of urine, and recent psychomotor retardation with cognitive slowing.Normal pressure hydrocephalus
- A 69-year-old accountant with poorly controlled hypertension shows a sudden, stepwise decline in executive function three months after an episode of transient right-sided weakness.Vascular neurocognitive disorder
Answer
The presentations map respectively to frontotemporal dementia (early behavior changes and disinhibition), dementia with Lewy bodies (visual hallucinations and parkinsonism), normal pressure hydrocephalus (classic triad of gait disturbance, incontinence, and dementia), and vascular dementia (stepwise decline following a cerebrovascular event).
Each clinical presentation contains classic pathognomonic features that align with specific diagnostic criteria for the major neurocognitive disorders, allowing clear differentiation between them.
Step-by-Step Solution
Key Concept
Differential diagnosis of major neurocognitive disorders based on core clinical criteria and timeline of symptom onset.