Family Nurse Practitioner Exam

What is the most likely diagnosis for a 44-year-old patient with Down syndrome who is exhibiting impaired memory and difficulty with daily routines?

1. Tic douloureux

2. A stroke

3. Alzheimer's disease

4. Delirium

The correct answer is: Alzheimer's disease

The most likely diagnosis for a 44-year-old patient with Down syndrome who is exhibiting impaired memory and difficulty with daily routines is Alzheimer's disease. Individuals with Down syndrome are at an increased risk of developing early-onset Alzheimer's, often showing symptoms in their 40s. This increased risk is attributed to the presence of an extra chromosome 21, which is associated with the overproduction of amyloid precursor protein, leading to the development of amyloid plaques and neurofibrillary tangles typical of Alzheimer's pathology. In this case, the patient's impaired memory and difficulties with daily routines are indicative of cognitive decline, a hallmark symptom of Alzheimer's disease. As the disease progresses, individuals may also struggle with communication, problem-solving, and performing familiar tasks, which aligns with the patient's difficulties. Delirium, although it can cause confusion and memory issues, is typically acute and often resolves once the underlying cause is treated. Stroke, while it can cause sudden cognitive changes, would likely present with differing neurological deficits depending on the area of the brain affected. Tic douloureux, or trigeminal neuralgia, primarily affects facial pain and would not typically present with memory impairment. Thus, the clinical presentation, combined with the patient's background, strongly supports Alzheimer's disease as the most likely