Scenario: You are a psychiatrist in the memory clinic seeing Mr. Graham Ellis, a 78-year-old retired accountant, with his son Michael. Mr. Ellis was referred by his GP with progressive memory problems over 18 months. Assessment reveals: MMSE 19/30, MoCA 15/30, with particular difficulties in short-term memory, word-finding, and orientation to time. MRI shows generalized cerebral atrophy with hippocampal volume loss. Blood tests (B12, folate, TFTs, calcium) were normal. There is no significant vascular disease on imaging. He has difficulty managing his finances, gets lost in familiar places, repeats questions, and has poor insight into his difficulties. You have diagnosed Alzheimer’s dementia. Today you need to explain the diagnosis and discuss management to Mr Ellis’s son Michael, including medication options. Your tasks are to: Address concerns and answer questions, explain the diagnosis of Alzheimer’s disease, discuss what causes it and the typical course, explain management including medication, discuss non-pharmacological support.
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Disclaimer: This video is intended for educational purposes only, targeted for the CASC exam – taken by psychiatry UK trainees in order to achieve membership of the Royal College of Psychiatrists. It should not be taken as clinical guidance or advice. It is also not intended to be an accurate portrayal of a real psychiatry consultation. For those revising for the CASC exam, this video should be used as a guidance and does not necessarily depict a gold-standard approach. Depending on when this video is viewed, information may be outdated.
Video Contributors:
Dr Leola Foscoe is a Psychiatry Speciality Registrar, specialising in Older Adults Psychiatry.
Dr Damir Rafi is a Psychiatry Speciality Registrar in Forensic Psychiatry, currently working in London.