The consequences of overlooking dementia in an elderly patient can be catastrophic. Nevertheless, studies indicate that many, if not most, cases are not recognized by patients, families, or physicians. Most patients are unaware of their cognitive impairment.
Families tend to dismiss it as part of the normal aging process.
Hence, the onus of recognition rests with physicians. Dr. Larson is Medical Director, University of Washington Medical Center, and Professor of Medicine and Adjunct Professor of Health Services, University of Washington School of Medicine, Seattle. Her vital signs are stable. There are no peritoneal signs, and the screening cardiopulmonary examination reveals no life-threatening findings. You arrange for her to be taken to radiology for kidney, ureter, bladder, and upright x-rays.