An 83-year-old woman is brought by her daughter for evaluation because
of increasing confusion during the past few days. The patient
has early Alzheimer dementia, hypertension, and type 2 diabetes. She takes donepezil, 10 mg/d;
lisinopril, 5 mg/d; and glipizide, 5 mg bid. She is unable to bathe and dress herself as well as previously,
has been crying for no apparent reason, and has lost her appetite.