Pre PACES Podcast #80 Memory loss
Feb 4, 2024
Dr Dan Firmage, consultant in geriatric medicine and PACES examiner, guides listeners through assessing cognitive impairment. Short takes cover differential diagnoses, memory types, red flags and safety risks. He outlines focused exams, essential tests and imaging choices. Practical tips on communication, multidisciplinary management and considerations for young-onset cases round out the discussion.
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Probe Safety Red Flags Early
- Do screen for safety red flags early: leaving gas or iron on, wandering, getting lost, or unsafe driving.
- Ask directly if family feel safe with the patient driving and probe for recent incidents or near-misses.
Social Details Reveal Functional Impact
- Insight: Social history reveals function and distinguishes memory impairment from frailty-related care needs.
- Ask who helps with meals, cleaning, dressing and prescriptions to map support, care needs and ability to prove need to services.
Check Drug Burden And Adherence
- Do review drug history for anticholinergic burden and adherence problems as reversible contributors to cognitive impairment.
- Check for amitriptyline, antipsychotics, oxybutynin, prochlorperazine, digoxin and dosing mistakes or unused doset boxes.