20th July 2023

An 82-year-old man presents with progressive confusion and is now having difficulty carrying out his daily activities independently.

An 82-year-old man presents with progressive confusion and is now having difficulty carrying out his daily activities independently. His son tells you that his father started forgetting things about five years ago. He has periods where he seems to plateau, but then seems to deteriorate at intervals. The patient has a history of hypertension, alcohol excess, anxiety and a 45 pack-year smoking history. CT imaging shows diffuse deep periventricular white matter changes.

What is the most likely diagnosis?

Select the SINGLE most appropriate option from the list below. Select ONE option only.