23rd February 2024

An 80 year old female attends the GP surgery with her son who is concerned that her memory has continued to deteriorate despite taking Donepezil 10mg once daily for several months.

An 80 year old female attends the GP surgery with her son who is concerned that her memory has continued to deteriorate despite taking Donepezil 10mg once daily for several months. He reports that her long-term memory appears to remain intact however her ability to remember day-to-day activities is severely affected and has started to have an impact on how well she can care for herself at home. A MMSE is conducted and she scores 12/30. The patient is otherwise well and a recent blood test including thyroid function showed no abnormalities except for mildly low ferritin levels. Her past medical history includes asthma and hypothyroidism for which she takes Levothyroxine 50 micrograms once daily.

Select the single, most appropriate management option at this stage.