Core IM | Internal Medicine Podcast #201: Dementia Part 1: Gray Matters Segment
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Feb 25, 2026 They walk through how to recognize when memory concerns should take visit primacy. Practical phrasing and involving family are discussed for sensitive cognitive screening. Listeners hear which brief tests and staging tools to use and when to stop screening and document function. The conversation covers reversible contributors, initial labs, and when brain imaging or advanced biomarkers are indicated.
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Ask How's Your Brain And About Sleep
- Ask direct but nonthreatening screening questions like “How's your brain?” and “How is your sleep?” to open the conversation.
- Use sleep as a gateway because sleep disorders and REM behaviors can indicate treatable contributors or Lewy body disease.
Stop Anticholinergics And Review OTC Sleep Aids
- Reconcile prescriptions and over‑the‑counter meds, especially ask about sleep aids and anticholinergics like diphenhydramine.
- Stopping oxybutynin or Benadryl can reverse cognitive symptoms in some patients.
Medication Changes Reversed Cognitive Symptoms In Cases
- Dr. Emily Citrone stopped nightly Benadryl for a patient and their cognitive decline cleared.
- Another patient improved dramatically after stopping oxybutynin, illustrating medication reversibility.