Eleanor R.

Third CaringAI Listen screen completed Jul 28, 2026, nine minutes forty seconds, patient at home, no caregiver present. MyCog total 24 of 30, identical to the March screen and one point below August 2025. Delayed recall two of three words. PHQ-9 four. IADLs unchanged, still managing her own medications and finances, gave up night driving in the spring on her own initiative.

She reported that everything is fine and that she is sleeping well. She named both recalled words without prompting but took four point one seconds to produce the second one and never retrieved the third, filling the gap with "it's right there, I can see it." That phrasing has now appeared on all three screens. Clarity read the retrieval effort as materially higher than March despite the identical total. Her daughter left a voicemail the same week asking whether repeating stories at dinner was worth mentioning. It was. Full screening call transcript.

Plan: hold the annual interval and bring her forward to a four month recheck. Repeat TSH and B12, both due. Refer to neuropsychology for formal testing given a flat score with a rising effort trend. Offer the caregiver a call with the navigator. Care plan refreshed the same day, see care plan generated Jul 28.

MRI brain without contrast, Jun 18, 2026, ordered by Dr. Whitfield as part of the cognitive workup. Findings: mild generalized volume loss appropriate for age with slightly disproportionate medial temporal atrophy, right greater than left, scored at 2 on the Scheltens medial temporal atrophy scale. Scattered T2 and FLAIR hyperintensities in the periventricular and deep white matter, Fazekas grade 1. No acute infarct, no restricted diffusion, no mass, no extra axial collection, no microhemorrhage on susceptibility weighted imaging.

Impression: mild medial temporal predominant atrophy with minimal small vessel ischemic change. Findings are compatible with early amnestic mild cognitive impairment but are not diagnostic on their own. Correlation with serial cognitive assessment recommended, which is the point of the four month recheck.