Hollis T.

First CaringAI Listen screen completed Jul 26, 2026, eleven minutes twenty seconds, longest call in this week's cohort. Self referred through the patient hotline after his wife raised concerns about missed appointments and repeated questions over roughly eight months. MyCog total 26 of 30, delayed recall two of three, clock drawing not administered by phone. PHQ-9 eleven, which is moderate and higher than he volunteered. GAD-7 nine. Retired eighteen months ago from thirty one years as a machinist.

He described the concerns as his wife's rather than his own and returned to that framing three times. He also mentioned, once and briefly, that he stopped going to his Tuesday card game in the spring because it "got to be a lot to keep track of." Clarity has no trend on him yet, which is the honest position on a first screen. What the baseline does show is prosodic range at 39, low enough that the moderate PHQ-9 reads as consistent rather than incidental, and the two findings should be worked up together rather than sequentially.

Plan: treat depression and cognition in parallel, not in order. Start sertraline 25 mg with an in person review at four weeks. Repeat screen at eight weeks to establish whether the cognitive findings move with mood. Baseline bloods sent. Wife invited to the next call with the patient's consent, obtained on this call. No imaging yet, decision deferred to the eight week screen.

No neuroimaging at intake. With a moderate depression score sitting underneath the cognitive complaint, structural imaging before any treatment of mood risks anchoring the whole picture on an incidental finding, and the reversible cause has not been addressed yet.

Imaging decision explicitly deferred to the eight week repeat screen. MRI brain will be ordered at that point if the cognitive findings persist once the PHQ-9 has responded, or sooner if delayed recall drops further or any focal symptom appears in the interim.