Alzheimer Disease Diagnosed 1 in Medicine / Internal Medicine — 74yo Man | Neurology | SMLE Q#11843

A 74-year-old man with Alzheimer disease diagnosed 1 year ago is seen in clinic. He has been taking donepezil 10 mg nightly and is fully adherent without adverse effects. Over the past 3 months, his instrumental activities of daily living have worsened; he now needs help with medications and shopping but remains independent in basic self-care. There are no prominent behavioral symptoms or depressive features. Cognitive testing shows progression to moderate impairment compared with prior visits. Evaluation for reversible contributors has been unremarkable. What is the most appropriate adjustment to his medication regimen at this time?