A 50-year-old man is brought to the physician by his wife because of personality changes for 2 years and cognitive decli

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A 50-year-old man is brought to the physician by his wife because of personality changes for 2 years and cognitive decline for 3 months. His wife says, "He used to be such a kind and shy man, but now he screams at strangers for no apparent reason. The other day, he yelled at a woman at a convenience store for not ordering extra cheese in her sandwich. He said she needed the extra calcium ." She adds, "This has been going on for a while, but last month he almost invested all of our savings in a start-up company that was going to produce different kinds of hats strictly for dogs He wasn't like this before. He was a respected accountant. I stopped him, thank goodness, and it turned out to be a scam, anyway." She adds, "I'm worried about his physical safety, too, because I've had to search for him five times within the past couple of months after he got lost wandering around our neighborhood. We've lived there for 20 years " Neurologic examination shows a palmomental reflex and hyperreflexia throughout the upper and lower extremities. His mood appears normal except for occasional inappropriate cursing at thephysician. His Mini-Mental State Examination score is 21/30. A CT scan of the head shows disproportionate atrophy of the frontal lobes bilaterally. Which of the following is the most likely diagnosis?



A) Demeniia, Alzheimertype
B) Huntington disease
C) Multi-infarct(vascular)dementia
D) Parkinson disease
E) Pick disease