Coprophagia in Moderately Severe Dementia: Comprehensive Geriatric Assessment, Interdisciplinary Management, and the 5Ms

IntroductionBehavioral and psychological symptoms of dementia (BPSD) contribute substantially to functional decline, caregiver burden, hospitalization, and institutionalization [1,2].Their emergence warrants systematic assessment of medical and medicationrelated factors, particularly in patients with advanced dementia.Coprophagia is rare in dementia and has been described primarily in neurodegenerative disorders involving frontal or orbitofrontal circuits, in which impaired inhibitory control may result in impulsive, compulsive, or socially inappropriate behaviors [3,4].In advanced dementia, these symptoms often coexist with frailty, functional dependence, incontinence, sleep disturbances, fall risk, and polypharmacy.Comprehensive geriatric assessment (CGA) helps identify interactions among these domains and prioritize individualized interventions [5].The 5Ms framework-Mind, Mobility, Medications, Multicomplexity, and Matters Most-provides a person-centered structure for clinical decision-making [6].In this case, it was used to link clinical problems with assessment, intervention, monitoring, and outcomes.