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Psych CASC / OSCEOld age psychiatry — Alzheimer disease

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.

communication3 min readVerification in progress

Target exams

FRANZCPMRCPsychABPNMD-DNB
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Study tools

Target exams

FRANZCPMRCPsychABPNMD-DNB
Prompt
A 71-year-old man with probable mild Alzheimer disease dementia and his wife want a plain-language explanation of the diagnosis, what tests mean, why donepezil is suggested, what to expect from treatment, safety (driving, wandering), and how behavioural changes will be handled without jumping to strong sedatives.

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]

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References5ShowHide
  1. [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. [2]Birks JS, Harvey RJ Donepezil for dementia due to Alzheimer's disease Cochrane Database Syst Rev, 2018.PMID 29923184
  3. [3]Kales HC, Gitlin LN, Lyketsos CG Assessment and management of behavioral and psychological symptoms of dementia BMJ, 2015.PMID 25731881
  4. [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. [5]Livingston G, Huntley J, Sommerlad A, et al. Dementia prevention, intervention, and care: 2020 report of the Lancet Commission Lancet, 2020.PMID 32738937
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