37 Alzheimer’s Dementia
Name: Alice Howland
Source: Still Alice by Lisa Genova (book, 2007)
Background Information
Alice Howland is a Caucasian female who is 50 years old. She currently works as a cognitive psychology professor at Harvard University. Overall, Howland presents as a healthy 50-year-old woman. Howland is a petite woman, but not underweight. Howland remains active in her work and social life and other than leading a hectic life appears happy. Howland lives with her husband (John) and the two have three grown children, all of which live out of the home. Howland maintains many close friendships and is in a stable, long-term relationship. Howland does not have any reported drug or alcohol related history. Howland states that she may have a glass or two of wine with dinner, but the only medication she takes is a multivitamin. Howland has not had any head injuries or serious health issues. Howland’s mother and sister died in a car accident when she was 18 and her father died the previous year from Cirrhosis of the liver. Howland allowed that her father was an alcoholic and that they did not have much contact over the last several years before his death.
Description of the Problem
Howland frequently exhibits disorientation and gets lost when she is only a few blocks from her home. She recognizes the building and knows that she is supposed to know how to get home, but her mind is blank. Howland frequently misplaces items and is unable to find them. At times, she replaces items and later finds the lost item. She frequently loses her train of thought, or is unable to remember significant details of her life. As a professor, she often visited other universities as a guest speaker or would present at conferences, lately, she would lose track near the middle to end of her lecture and have to refer to her notes. This was not common for Howland as she used her speeches repeatedly only making small changes that were easy to remember. Howland reports forgetting words during a lecture, she states that it is not even on the tip of her tongue; the word is just completely gone from her memory. Howland recently missed a conference in Chicago, simply because she forgot about it. Howland also states that she has to write down a detailed schedule of what time and where her classes are or she will simply forget to go teach them.
Diagnosis
Dementia of the Alzheimer’s Type (294.1x)
Diagnostic criteria:
- The development of multiple cognitive deficits manifested by both
- (1) memory impairment (impaired ability to learn new information or to recall previously learned information)
- (2) one (or more) of the following cognitive disturbances:
- aphasia (language disturbance)
- apraxia (impaired ability to carry out motor activities despite intact motor function)
- agnosia (failure to recognize or identify objects despite intact sensory function)
- disturbance in executive functioning (i.e. planning, organizing, sequencing, abstracting)
- The cognitive deficits in