An 80 Year Old Man Brought With A Noticeable Change In His Personality

An 80-year-old man is brought in by his wife. She complains her husband has had a noticeable change in his personality. He is impulsive and at times inappropriate with his behavior. Although he has difficulty naming objects, his memory, ability to calculate, and his visuospatial skills appear
to be intact.
The most likely diagnosis is

A) Alzhemier's Disease
B) Pick’s disease
C) Parkinson’s disease
D) Wilson’s disease
E) Lewy body dementia

Answer and Discussion

The answer is B.(Pick’s disease)

 Pick’s disease and other frontotemporal dementias (FTD) are a heterogeneous group of disorders that share several clinical features with AD such as rate of progression and duration. Many frontotemporal dementias patients are also aphasic and manifest preserved motor integrity.
The language disturbance characteristic of Pick’s disease initially includes anomia, but there is a more stereotyped and perseverative verbal output than that found in AD. Unlike AD, in the early stages of frontotemporal dementias, memory, calculation, and visuospatial function are relatively
well preserved.
The most striking feature of this disorder is an extravagant change in the patient’s personality, including disinhibition, impulsivity, inappropriate jocularity, and intrusiveness.

Patients with Parkinson’s disease with dementia typically show deficits on tests of executive function,
visuospatial abilities, and verbal fluency.

Symptoms in Wilson’s disease usually appear between 6 and 20 years of age, and although cases in older people have been described, psychiatric symptoms are accompanied by neurological symptoms.

Lewy body dementia is often accompanied by delirium.