A 75-year-old man is hospitalized for cellulitis in his leg….

A 75-year-old man is hospitalized for cellulitis in his leg. Psychiatry is consulted because the man’s daughter is worried that her father seems “a little off.” On examination, the patient is well-appearing, alert, and attentive, with a euthymic reactive affect. He denies any complaints aside from leg pain. Although he is oriented to person, place, and month and year, he is unable to remember the exact date. He is able to recall only two out of three words on a short-term memory test. The patient’s daughter notes that although her father lives independently, he has “slowed down a little” over the past few months and takes “a long time” to balance his checkbook, which surprises her because he worked as an accountant until a year ago. What is the most likely diagnosis?

A 68-year-old male is brought to see his primary care provid…

A 68-year-old male is brought to see his primary care provider by his daughter who is concerned about him. According to his daughter, the patient experienced the death of his wife six months ago and since then has had a “major decline” in his ability to function. His daughter now feels the need to stop by his house at least once per day to ensure that they are meals available for him to eat “or else he will probably just starve.” He scores a 14/30 on the MoCA, with points lost primarily for several tasks which he declined to attempt (“That sounds like a lot of work. What’s the point of all this? I want to go home.”). When asked about his memory, he says, “Yeah, I forget things all the time. Phone numbers, names, dates – they’re all gone.” He reports difficulty sleeping at night and says that sometimes he hears the voice of his wife “calling out my name.” Which of the following most strongly argues against a diagnosis of Alzheimer’s disease for this patient?