ABSTRACT
A 66-year-old man presented to hospital following a fall at home. He recalled tripping over a rug and falling onto his left side without sustaining a head injury. His wife accompanied him and described two additional falls at home over the preceding week. She asked to speak privately with the junior doctor and said that she had become increasingly concerned about her husband in recent weeks. He had been irritable and had been asked to leave his job following an argument with his boss. He had been struggling to remember the names of his children, forgetting to turn the gas off after cooking and losing his belongings. One week earlier, she had found him sitting in the front garden as he could not remember how to open the front door. She also thought that he may be occasionally responding to auditory hallucinations. Until 6 weeks ago, he had been fit and well. His past history included hypertension and diet-controlled type 2 diabetes mellitus. He took losartan for his hypertension and a multivitamin each day. He worked as a senior manager at a building society until recently. He did not smoke and typically drank around 8 units of alcohol per week, although his wife reported that this had increased recently.
