Thank you so much for referring Ms. Choi to the geriatric assessment. The main concern is that of cognitive decline. This is an 85-year-old woman born in China and who arrived in Canada over 30 years ago. She is married and lives with her husband in a cooperative apartment. They have 5 children, 3 boys and 2 girls. One of the sons is in Toronto and one of the daughters is also in Toronto. speaks Cantonese. She is a retired part-time cleaner. He had no formal education. Her son, Mr. Choi, is present with her for the interview today. He had been complaining of a decline in his cognitive abilities for over 5 years. She is forgetful in conversations and has diminishing understanding. It's getting worse over time. There are no hallucinations or delusions. There is no story of loss. He recognizes his family and friends. He has no history of late payment of invoices. He does the shopping and does the laundry. Once she went to a restaurant and left her purse there. He returned and then found it. She had paid for her meal but had forgotten to bring her purse with her. He also left an umbrella on the bus. He sleeps 5-6 hours at night and wakes up easily. He wakes up early in the morning around 4:00-5:00. During the day he takes naps for 0.5-1 hour, but not every day. He had lost his appetite and weight. He lost about 7-8 kilos in more than 2 years. She takes care of her husband who is 95 years old. He walks with a Rollator walker. He has macular degeneration and needs help. It offers meals on wheels and also CCAC twice a week. She said that her husband's character is bad because of his illness. He takes it out on her and so she is not happy. His mood is low. Last year she had fallen twice on the TTC or the subway. She fell... in the middle of the paper... has subjective symptoms of decreased cognitive ability, but the MMSE is well maintained within the normal range with no evidence of short-term recall problems. The clock drawing test is quite normal. The findings do not suggest Alzheimer's disease or other forms of dementia. I would think that the incidence of forgetting personal items may be a sign of stress and perhaps depression on the part of the caregiver, as she is stressed providing care to her elderly husband who is not in good spirits due to his health problems. I offered her a trial of 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 you to come back to see me and thank you so much for reporting this to me lady.