Geriatric Medicine

Question 1

Dementia Rx

Answer 1

Donepezil, an acetylcholinesterase inhibitor, is recommended for the management of mild to moderate Alzheimer’s disease.
Memantine is typically used for moderate to severe Alzheimer’s disease or for patients intolerant to acetylcholinesterase inhibitors.

Question 2

Sleep problem in Old age

Answer 2

Non-pharmacological interventions, such as sleep hygiene, are the first-line approach to managing sleep disturbances in people with dementia. Melatonin may be considered if these measures are insufficient.

Question 3

Normal pressure Hydrocephalus

Answer 3

A classical triad of features is seen
urinary incontinence
dementia and bradyphrenia
gait abnormality (may be similar to Parkinson’s disease)

Question 4

DELIRIUM

Answer 4

Factors favouring delirium over dementia
acute onset

impairment of consciousness
fluctuation of symptoms: worse at night, periods of normality
abnormal perception (e.g. illusions and hallucinations)
agitation, fear
delusions