23rd August 2024

A 73-year-old woman attends clinic due to problems with her walking. She attends with her neighbour

A 73-year-old woman attends clinic due to problems with her walking. She attends with her neighbour who reports that two years ago she was able to walk to the local shops in 15 minutes but after having a couple of falls she now needs her neighbour to do her shopping for her. She used to be ‘fairly sharp’ but has become much slower to process information and her neighbour has found her incontinent of urine several times when she has dropped off her shopping.

On examination, she has a broad based, hesitant and shuffling gait with difficulties turning around furniture. There are no other peripheral signs of parkinsonism and her CT brain is unremarkable.

What is the next step in management?

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