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This case is about the diagnosis of Alzheimer's at a relatively young age, at a time when the patients are forced to juggle jobs, family, and dementia. The case is based on the article When Alzheimer's Hits at 40 from the Wall Street Journal (November 14, 2008). While most people who get Alzheimer's are over 65, Andy Smith, the protagonist in the case, is one of about 500,000 Americans living with Alzheimer's or other dementias at an atypically young age. Alzheimer's takes a long time to develop - usually, it isn't diagnosed until 10 years after the first symptoms appear - but more Americans are identifying it early, thanks in part to aggressive screening programs pushed in recent years by groups including the Alzheimer's Foundation of America, a national alliance of caregivers. This case has three vignettes that focus on different difficult conversations between Dr Henderson and Andy and Cindy Smith. Dr Henderson is there at the beginning of this ordeal as he attempts to inconclusively identify the cause of Andy's initial symptoms. Finally, after several years and many different treatments, Dr Henderson diagnosed Andy's condition as Alzheimer's.