Probable Alzheimer Disease Has in Medicine / Internal Medicine — 74yo Man | Neurology | SMLE Q#17884

SMLE Question #17884

Medicine / Internal Medicine Neurology

Objective: OBJ-NEURO-AD-THERAPY-001

Last updated: February 2026
A 74-year-old man with probable Alzheimer disease has progressive memory decline affecting daily activities for 6 months. He has taken donepezil 10 mg daily with good adherence and tolerates it. His Mini-Mental State Examination score decreased from 19 to 12 over 6 months. Brain MRI shows bilateral hippocampal atrophy without acute infarct or mass. He has no hallucinations, depressive symptoms, or focal neurologic deficits. What is the most appropriate next step in pharmacologic management of his cognitive decline?

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