Well-patient care (geriatrics) Quiz: Ace Your Exams

A 77-year-old woman presents to her primary care physician for a routine yearly visit. The patient has been well since her last visit without new concerns. She has a history of hypertension for which she takes hydrochlorothiazide and newly diagnosed Parkinson disease. The patient has not yet been seen by a neurologist and has an appointment scheduled for next week. The patient has no other significant medical or surgical history. The patient’s mother died of metastatic lung cancer, and the patient’s father died of an abdominal aortic aneurysm. The patient drinks 1-2 alcoholic beverages each week, and she smoked one pack per day for 5 years when she was in her 40’s. She lives with her partner and has had several falls over the past six months. Temperature is 37°C (98.6°F), blood pressure is 134/60 mmHg, heart rate is 80 beats per minute, respiratory rate is 16 breaths per minute, and oxygen saturation is 97% on room air. BMI is 26.7 kg/m². The patient is well-appearing, and a full physical examination is unremarkable except for a pin rolling tremor and masked facies. Which of the following is the best next step in management?