Case Report: Alzheimer’s Disease

Alzheimer’s disease (AD) poses a significant threat to aviation safety due to its insidious cognitive decline. The early stage, mild cognitive impairment (MCI), is challenging to detect in high-functioning individuals like pilots, yet any impairment requires strict aeromedical evaluation. This case involved a 60-year-old commercial pilot with over 20,000 flight hours who presented with a one-year history of gradual cognitive decline. Initially dismissed as stress, these symptoms were eventually noted by colleagues. A comprehensive evaluation, including neuropsychological testing and a brain magnetic resonance imaging revealing hippocampal atrophy, led to a diagnosis of MCI due to AD. He began treatment with a cholinesterase inhibitor. However, given AD’s progressive nature on functions vital for flight and potential medication side effects, he was disqualified from duty permanently. This case underscores the critical need for effective cognitive screening protocols and robust aeromedical guidelines for pilots with neurodegenerative conditions to ensure aviation safety.