John is 83 years of age, round faced, tanned, cheerful, smiling a shock of white hair and a slight roll as he walks. A picture of health, strong legs and a good gait, he always comes into the clinic room first followed his wife. She is 77 years, slim, even underweight, walking more slowly than John and the waddle in her gait is due to pain and stiffness in her right hip. John, my patient, always greets me with a cheery “Hello, Doctor”. I’m not sure if this is rehearsed in the waiting room or whether he is reminded on his way down the corridor by his wife, Maureen. The expected question from me is always followed by “very well, thank you Doctor”. The next question from me is hardly considered before he looks at his wife to respond. No recollection of their recent holiday. No idea of where we are today or, needless to say, time or date. Quickly, Maureen takes over, anxiety shown in the deep lines on her forehead. Her smile is there but weak and uncertain.