Published online by Cambridge University Press: 03 November 2020
This 76-year-old man returned to the clinic, brought by his daughter for monitoring of his progressive memory impairment. Five years previously, neuropsychological evaluation revealed memory encoding deficits and brain MRI showed asymmetric hippocampal atrophy. With a diagnosis of probable Alzheimer disease, he was started on rivastigmine, gradually increased to a dose of 6 mg BID. The family noticed better thinking and less forgetfulness for six months, but he continued to decline thereafter. He went on to have difficulty dressing and bathing and experienced delusions of theft. After five years of treatment with rivastigmine, his daughter wondered if it should be discontinued.