intermediatemajor neurocognitive disorderdementia workupMoCAneuroimagingbrain MRIdiagnostic workupgeriatric psychiatry
A 72-year-old male is brought to the clinic by his daughter who reports progressive memory decline over the past 18 months. She states he has gotten lost driving to familiar locations, has forgotten to pay bills resulting in utility shutoffs, and recently left the stove on overnight. The patient scores 18/30 on the MoCA and 3/5 on delayed word recall. His basic metabolic panel, CBC, TSH, vitamin B12, folate, and RPR are all within normal limits. He has no history of substance use, head trauma, or psychiatric illness. His daughter reports these changes represent a significant decline from his prior level of functioning, as he previously managed all household finances independently. The PMHNP is determining the next most appropriate step in the diagnostic workup. Which of the following is the MOST appropriate next step?