A 60 year old male patient exhibits excessive sleepiness, slowing of movements, mild depression and proximal muscle weakness. Serology shows normal  blood calcium and increased creatinine with reduced creatinine clearance. The patient has had joint swellings and  abdominal discomfort for several months . what is most likely diagnosis
The appearance of pseudogout in elderly patients should raise the probability of hyperparathyroidism. Blood calcium levels may be normal when checked , but parathyroid hormone levels will be elevated.
Hypermagnesemia
Hepatolenticular degeneration
Hyperparathyroidism
Akinetic mutism