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Dementia assessment — RACGP Fellowship MCQ

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HardGeriatricsDementia assessmentRACGP Fellowship

A 78-year-old man presents with progressive memory decline over 18 months. His daughter reports missed bills and getting lost. MMSE is 23/30. B12 and TSH are normal. CT brain shows generalised atrophy without mass or subdural haematoma. What is the most appropriate management?

Educational content. Not a substitute for clinical judgement or local policy.

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Correct answer: B — Diagnose probable dementia, assess functional capacity and driving safety, and arrange community support and care planning

Option B is correct. Australian primary care guidelines emphasise comprehensive assessment after diagnosing probable dementia—including functional status, driving safety and planning support services. RACGP guidelines recommend discussing activities of daily living and safety (e.g. driving), providing carer support, and care planning post-diagnosis. Distractors are unsafe or inappropriate: A ignores proven clinical decline; B treats a nonexistent infection; C avoids an ethically and legally required safety discussion; D prescribes a sedative harmful to cognition. This reflects the multi-step reasoning expected at the Hard level.

Reference: RACGP AFP December 2016 Clinical practice guidelines for dementia; RACGP AFP December 2012 Dementia management update