Thank you very much for recommending Ms. Choi for a geriatric evaluation. The main concern is that of decreased cognition. This is an 85-year-old lady, born in China and coming to Canada for more than 30 years. She is married and lives with her husband in a cooperative apartment. They have 5 children, 3 sons and 2 daughters. One of the sons is in Toronto and one of the daughters is also in Toronto. she speaks Cantonese. She is a retired part-time housekeeper. She had no formal education. Her son, Mr. Choi, is present with her for today's interview. She had been complaining of a decline in her cognition for over 5 years. She forgets conversations and her understanding diminishes. It gets worse over time. There are no hallucinations or delusions. There is no story of loss. She recognizes her family and friends. She has no history of late payment of bills. She does the grocery shopping and laundry. She once went to a restaurant and left her purse there. She came back and found it. She had paid for the meal but had forgotten to take the bag with her. She also left an umbrella on the bus. She sleeps 5 to 6 hours at night and wakes up easily. She wakes up early in the morning around 4:00-5:00 am. She takes naps during the day for 0.5 to 1 hour, but not every day. She had lost her appetite and her weight. She lost about 7-8 pounds in over 2 years. She takes care of her husband who is 95 years old. He walks with a Rollator walker. He suffers from macular degeneration and needs help. It offers meals on wheels and also CASC twice a week. She said her husband's character was bad because of his illness. He attacks her and so she is not happy. His mood is bad. Last year, she fell twice on the TTC or on the subway. She fell ... middle of paper ...... sends with subjective symptoms of decreased cognition, but MMSE is well maintained within the normal range with no evidence of short-term recall problems. The clock drawing test is pretty normal. The results do not suggest Alzheimer's disease or other forms of dementia. I think the cases of forgotten possessions could well be a sign of stress and possibly depression in the caregiver, as she is stressed about providing care to her elderly husband who is also not in good health mood because of his own health problems. I suggested she try antidepressants, specifically Remeron, but she refused. I reassured her that there is no evidence of Alzheimer's disease and that the MMSE score is very good considering she has no formal education. I haven't made an appointment for her to come see me again, and thank you very much for referring me to that. lady.