Dressing in Medicine / Internal Medicine — 76yo Woman | Psychiatry | SMLE Q#1494

SMLE Question #1494

Medicine / Internal Medicine Psychiatry
Last updated: February 2026
A 76-year-old woman has had progressive cognitive decline for 4 years. She has severe impairment in recent memory and daily functioning; she forgets family members’ names, gets lost at home, and needs help with dressing, bathing, and feeding. She cannot manage medications or finances and cannot participate meaningfully in conversations. Her Mini-Mental State Examination score is 10/30. Nonpharmacologic measures have been optimized. She has symptomatic sinus bradycardia and a history of first-degree AV block. Which of the following is the most appropriate pharmacologic treatment at this stage?

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