The Valproate Trap: When Parkinson’s" and Dementia Are Found in a Pillbox Prepared by Dr. Khaw Mae Jane Supervised by Dato Dr. Tunku Muzafar Shah, Dr. Chee Sing Hui Case Summary Patient Profile Background Mdm PCL is a 64-year-old Chinese lady (Clinical Frailty Scale 4) who was referred to the Geriatrics Clinic from a private neuropsychiatry practice. She lives with her 73-year-old husband in an urban condominium. She demonstrates excellent functional capacity, independently managing...

Heart Failure Treatment in Frail Older Adults: Balancing Guidelines and Individual Needs Prepared by Dr Siti Khairizan Rahim Supervised by Dr Rizah Mazzuin Razali Case Summary Heart failure in older adults significantly aggravates frailty, malnutrition and cachexia and impacts overall prognosis. Frailty causes further functional decline, hospitalisation, longer hospital stays and a higher mortality rate. While malnutrition in heart failure is due to appetite loss, malabsorption, and a...

The Upholding of the No- A broken toenail to the end of life Prepared by: Navena Sharma Supervisor: Dr Yusliza Azreen Case Summary Madam M, a 71 year old lady with diabetes mellitus, hypertension, and significant vascular comorbidities, had a history of right below knee amputation (2020) and lacunar infarct (2022) without residual neurological deficit; clinical frailty scale of 6. Wheel chair bound since her amputation, she required assistance with transfers and showering but remained fairly...