Psych CASC / OSCE · Old age psychiatry — Alzheimer disease
Explain Alzheimer disease diagnosis and treatment plan to patient and spouse — CASC communication station
MRCPsych/FRANZCP-style communication station: explain AD diagnosis, care plan, donepezil start with monitoring, BPSD non-drug first approach, and check understanding.
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Target exams
Station brief
Format. Communication station, approximately 7–10 minutes active time after reading. You are the psychiatry registrar in the memory clinic / old-age outpatient setting. [1]
Candidate instructions. Explain probable Alzheimer disease in plain language; address fear that "nothing can be done"; outline blood tests and brain scan purpose without overselling optional research biomarkers; explain starting donepezil with realistic benefits and side-effects; cover driving and safety; explain that behavioural changes are common and usually managed without strong sedatives first; check understanding. Examiner plays the patient; a second role-player may be the spouse. [1][2]
References5ShowHide
- [1]McKhann GM, Knopman DS, Chertkow H, et al. The diagnosis of dementia due to Alzheimer's disease: recommendations from the National Institute on Aging-Alzheimer's Association workgroups Alzheimers Dement, 2011.PMID 21514250
- [2]Birks JS, Harvey RJ Donepezil for dementia due to Alzheimer's disease Cochrane Database Syst Rev, 2018.PMID 29923184
- [3]Kales HC, Gitlin LN, Lyketsos CG Assessment and management of behavioral and psychological symptoms of dementia BMJ, 2015.PMID 25731881
- [4]Schneider LS, Dagerman KS, Insel P Risk of death with atypical antipsychotic drug treatment for dementia: meta-analysis of randomized placebo-controlled trials JAMA, 2005.PMID 16234500
- [5]Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission Lancet, 2020.PMID 32738937