Question

an elderly patient has symptoms of depression and the patients daughter asks about possible alzheimers disease (ad) since there is a family history of this disease. a screening evaluation shows no memory loss. what is the initial step in managing this patient?
order brain imaging studies such as ct or mri.
perform genetic testing to identify true risk.
prescribe a trial of an antidepressant medication.
recommend a trial of a cholinesterase inhibitor drug.

Explanation:

The patient has symptoms of depression but no memory loss. In such cases, the initial step is to address the presenting symptom (depression). Prescribing a trial of an antidepressant medication is appropriate as it directly targets the depression. Brain imaging (CT/MRI) is more for ruling out structural brain issues when there are concerns like focal neurological signs (not mentioned here). Genetic testing for AD risk is not the initial step for a patient with depression symptoms. Cholinesterase inhibitors are for AD (patient has no memory loss, so not indicated initially).

Answer:

Prescribe a trial of an antidepressant medication.