Rebecca Winter is an Elderly Medicine registrar; she is currently taking a year out of programme as a Clinical Education Fellow at Brighton and Sussex Medical School (BSMS). Twitter: @rebeccawinter27
Muna Al-Jawad is an Elderly medicine consultant at the Royal Sussex County Hospital, Brighton. She works on a mixed acute medical and mental health ward.
It’s a familiar scenario, you are on your Elderly Medicine placement and you are asked: “Can you get collateral history about Mrs Smith´s cognition?” You don´t want to miss anything, but what exactly do they want to know?
Dementia is an increasingly common and important condition. In the UK, at least one quarter of acute hospital beds are occupied by patient with dementia, with admissions spread across a broad range of specialties. (1) Despite this, the UK National Dementia Strategy (2) has highlighted deficiencies in behaviour and skills of healthcare professionals caring for people with dementia.
Our passion includes teaching undergraduates and postgraduates within the Multidisciplinary team (MDT) about dementia care, and tips for communication. We realised that many people often do not know what is meant by a collateral history for cognition and just how important the collateral is to making an underlying diagnosis of dementia.
We have developed a mnemonic which has had a great effect on student performance at BSMS and the feedback has been overwhelmingly positive. It is based on the main cognitive domains of dementia and provides example questions of what to ask. It is of course, a guide to recall the six domains that may be affected by dementia and should be used as this. We hope that it is helpful to you.
- Royal college of psychiatrists: Who cares wins. Improving the care of older people admitted to the general hospital. Guidelines for the development of liason mental health services for older people. London: Royal college psychiatrists; 2005
- Department of Health: Living well with dementia: A National Dementia Strategy. London; 2009
British Geriatrics Society 
Dear Rebecca and Muna
Thank you for sharing this. A really nice piece of work which will help people taking collateral histories
Tahir Masud
A bit lost here…I still do not have a specific definition of your terms. Also, how may one view the mnemonic and define the six domains? Thanks.
Do you have a higher resolution version of the maple leaf graphic please? I’ve tried blowing up a saved picture but it is too blurred to make out the example questions under each domain. I would try to use it in my next talk on dementia with students and Foundation doctors to see what they think.
Dr Winter – v interested in any further progress that you have made with this. Full of potential! Kind regards Dr Robert Colgate