A 73-Year-Old Man Is Brought to the Physician by His

A 73-year-old man is brought to the physician by his daughter for evaluation of increasing forgetfulness during the past 6 months. The daughter reports that he recently got lost while walking home from the grocery store. The patient has also been more irritable but has had no movement or gait abnormalities, feelings of depression, hallucinations, or delusions. On mental status examination, he has a normal affect. He is oriented to person and place but cannot recall which month it is. There are no focal neurologic deficits.  Which of the following is most likely involved in the pathogenesis of this patient's condition?

A) Alpha-synuclein protein aggregation
B) CD4⁺ T lymphocytes activated by myelin basic protein
C) Inflammatory vasculitis affecting the arterioles
D) Microtubule-associated protein polymerization
E) Perivascular infiltration of virally infected macrophages

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