A 51-year-old male real estate lawyer began to embezzle money at work, regularly listing mysterious expenses on his travel reimbursement forms, which turned out to be purchases of pornographic materials via the internet. When questioned, he claimed that he used the corporate accounts so that his wife would not find out about this sexual activity. At about the time that this behavior was discovered by his partners, a few of the female law clerks complained that he often made inappropriate comments about their physique and that he stared at them in a way that made them uncomfortable. His work had dramatically deteriorated, and rather than working with his clients, he spent most of the day at work shuffling papers, reading magazines or downloading pornography onto his computer. He was eventually asked to leave the firm but made no attempts to find a new job. His wife and children reported that over the past year he had lost interest in them and watched television without speaking when at home. He developed a strong desire for potato chips and gained 15 lbs. His manners deteriorated, and he stuffed his mouth, often choking at the dinner table. He insisted on eating food on his plate in a specific order, often with his hands. Family history revealed that his father and first cousin had died from "Lou Gehrig's disease."
A successful graphic designer began to have trouble finding names for people and objects. He continued to design brochures and logos for small businesses but had trouble filling out paper orders, making frequent spelling mistakes. Surprisingly, he was caught stealing a shiny necklace from a client's store. Soon afterward he began to comb the beach, spending many hours looking for seashells. While at home he began to play solitaire compulsively for 6 hours per day. He developed a new interest in squash, and his game steadily improved. He stopped working as a graphic designer but obtained a courier job and learned and remembered a complex route for delivering packages. There was no family history of dementia.
A 62-year-old female retired executive began having difficulty finding words. She slowly began to lose her ability to express ideas. She became quieter and somewhat socially withdrawn. She also started to have trouble writing. When talking, she took a long time to express her ideas and communicated agrammatically with nouns. Others told her that she had trouble "spitting out her words." Social graces remained preserved, although she expressed profound frustration regarding her speech, and she developed a major depression. There was no family history of dementia.