23rd February 2024

A 79 year old female attends an appointment at her GP surgery with her son, who is concerned by his mother’s deterioration over the past 6 months.

A 79 year old female attends an appointment at her GP surgery with her son, who is concerned by his mother’s deterioration over the past 6 months. He is concerned that she sometimes appears confused and repeats questions multiple times. He also notes that whilst she can recall some of her childhood memories, her memory for more recent events has become much worse. On examination the patient appears anxious and cannot recall why she is there. Her mini-mental examination score is 14/30. She has a past medical history of iron-deficiency anaemia, hypertension and ulcerative colitis. She has no allergies. She is on Verapamil for hypertension. Recent blood tests and observations are as follows:

Hb 102, WCC 6.8, Platelets 345, Na 129, K+ 3.9, Urea 9, Creatinine 95

HR 52, BP 130/70, RR 18, Temp 36.4, O2 saturations 97% on room air.

Select the single, most appropriate management option for this patient’s cognitive impairment.