Chronic disease management: Anticholinergic medicines and dementia

Mrs Atkins, 78 years old, lives at home with her 80-year-old husband. She was diagnosed with Alzheimer's disease (AD) about fi ve years ago, and has progressed to moderate stage disease. She is dependent on her husband for most activities of daily living. Her extensive medical history includes hypertension, heart failure, hypercholesterolaemia, depression, osteoporosis, urge incontinence and constipation. Over the past few months Mrs Atkins has become increasingly agitated, has wandered outside the home twice, and has fallen repeatedly. She has been referred to you for a medication review.