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Primary Care

General Geriatric Medicine   

Questions discussed in this category

Do you have any pearls for how to manage OSA with CPAP in older adults with cognitive impairment?
1 Answer available
How do you approach the choice of pharmacological therapy when treating insomnia in older adults in the outpatient setting with a high falling risk?
Are there any pearls re: which therapies that may be slightly safer vs to be strongly avoided?
1 Answer available
What are the clinical prompts that lead you to consider deprescribing bisphosphonate therapy in older adults with osteoporosis?
1 Answer available
In adults ≥80 years with TSH 6–10 mIU/L and minimal symptoms, do you initiate levothyroxine, monitor, or avoid treatment entirely?
Does frailty change your threshold?
2 Answers available
How would you approach the consideration of continuing or ceasing colonoscopy for colon cancer screening in a relatively fit man in his 80s without a history of polyps on prior colonoscopies?
1 Answer available
What is your clinical approach to deprescribing vs continuing low-dose aspirin used for primary prevention in older adults who are already taking this medication?
Are there any pearls for strong factors that would push you towards vs away from deprescribing?
1 Answer available
In outpatient primary care settings, would you recommend routinely checking Cystatin-C as a marker of renal function in older adults?
3 Answers available
How would you approach counseling an older patient with significant hearing loss and nonadherence to use of hearing aids?
1 Answer available
How do you approach the management of newly discovered prediabetes in adults over the age of 65?
2 Answers available
How do you approach decision-making around initiation of osteoporosis therapy in patients with advanced dementia?
1 Answer available
What practical next steps would you recommend once identifying loneliness in an older adult patient?
1 Answer available
How do you determine whether to continue anti-dementia medications (such as cholinesterase inhibitors) for patients with dementia when enrolling in hospice?
3 Answers available
What patient factors are most important when considering who needs a broader workup for osteoporosis prior to starting therapy?
Do you routinely rule out secondary causes of osteoporosis (i.e., TSH) in all patients prior to starting therapy? If you work up all patients, what la...
1 Answer available
What are your thoughts about lion's mane supplementation to slow the decline or improve cognitive capacity for those at risk of dementia?
1 Answer available
What patient factors most strongly influence your decision to start biologic agents in mild cognitive impairment?
Specifically, what guidelines do you use to help determine this (if any)? 
1 Answer available
How would you approach the management of asymptomatic ALT and GGT elevation in an older adult patient with depression with psychosis and without history of hepatitis who recently had dose of quetiapine increased and new initiation of SNRI?
1 Answer available
How do you approach the management of extremely low LDL levels in older adult patients receiving statin therapy for primary prevention of cardiovascular disease?
1 Answer available
Would you recommend a GLP-1 agonist as an option to reduce the risk of dementia in patients with a strong family history?
As studied in Tang H, Donahoo WT, DeKosky ST, et al. GLP-1RA and SGLT2i Medications for Type 2 Diabetes and Alzheimer Disease and Related De...
1 Answer available
Other than oxybutynin or mirabegron, what pharmacological and non-pharmacological treatments would you consider for increased urinary frequency (not caused by infection, medications, or resulting in incontinence)?
1 Answer available
How do you counsel non-diabetic patients who wish to start metformin to reduce the risk of developing dementia?
2 Answers available
Do you recommend life long aspirin 81 mg daily for non-specific T2 white matter hyper-intensities on MRI brain?
7 Answers available


Papers discussed in this category

Lancet (London, England), 2015 Mar 12
A 2 year multidomain intervention of diet, exercise, cognitive training, and vascular risk monitoring versus control to prevent cognitive decline in at-risk elderly people (FINGER): a randomised controlled trial.
The American journal of geriatric psychiatry : official journal of the American Association for Geriatric Psychiatry, 2018-02
A Systematic Review of Practice Guidelines and Recommendations for Discontinuation of Cholinesterase Inhibitors in Dementia.
JAMA internal medicine, 2025 May 01
Continued Use of Cholinesterase Inhibitors and Memantine in Hospice.
Alzheimer's & dementia (New York, N. Y.), 2022 Jan 31
CCCDTD5 recommendations on the deprescribing of cognitive enhancers in dementia.
The Medical journal of Australia, 2019 Feb 16
Deprescribing cholinesterase inhibitors and memantine in dementia: guideline summary.
JAMA, 2025 Dec 02
Discordance in Creatinine- and Cystatin C-Based eGFR and Clinical Outcomes: A Meta-Analysis.
JAMA internal medicine, 2022 Jan 01
Time to Benefit of Bisphosphonate Therapy for the Prevention of Fractures Among Postmenopausal Women With Osteoporosis: A Meta-analysis of Randomized Clinical Trials.
Annals of internal medicine, 2023 Jan 03
Effectiveness and Safety of Treatments to Prevent Fractures in People With Low Bone Mass or Primary Osteoporosis: A Living Systematic Review and Network Meta-analysis for the American College of Physicians.
BMC endocrine disorders, 2017 Feb 03
Study protocol; Thyroid hormone Replacement for Untreated older adults with Subclinical hypothyroidism - a randomised placebo controlled Trial (TRUST).

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