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  1. Kallur Suresh, consultant in old age psychiatry and honorary senior lecturer1,
  2. David Smalley, general practitioner2,
  3. Zuzana Walker, senior lecturer and honorary consultant in psychiatry of the elderly3
  1. 1North Essex Partnership NHS Foundation Trust, Harlow, Essex CM20 1QX
  2. 2Nuffield House Surgery, Harlow, Essex
  3. 3Department of Mental Health Sciences, University College London, London
  1. Correspondence to: K Suresh kallur.suresh{at}nepft.nhs.uk
  • Accepted 3 May 2007

A 73 year old woman is brought by her daughter with a one year history of worsening forgetfulness. She lives on her own and has been knocking on neighbours’ doors in the middle of the night saying she needs to go shopping.

What issues you should cover

History—Gather as much detail about the forgetfulness as possible from the patient and her daughter. When did it begin? How was it noticed? What does she forget? Is it getting worse? Does she have insight? Does she misidentify people? Does she have difficulty in looking after herself? Is she incontinent? Does she remember to take her medications? Is she anxious or depressed? Is she eating and drinking enough? Is she paying her bills? Does she have any major medical problems such as stroke, transient ischaemic attack, diabetes mellitus, Parkinson’s disease? Does she have any risk factors for cerebrovascular disease? Does she smoke or drink alcohol excessively? What medication is she taking? A more detailed assessment may be carried out at a later …

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