How can you improve this medication regimen?

Case Study 1 (3pages): A 78-year-old man and his wife were both concerned that his memory was not as good as it was last year. He used to be able to remember a short grocery list in his head but now he needed to write it down or he would return with the wrong items. He continued to pay the bills, balance the books and do household projects although these tasks now took him longer to complete. Evaluation of memory testing in the office showed that he scored below normal when repeating a brief story containing 10 details. His laboratory data were unremarkable, and his MRI showed bilateral atrophy in hippocampus (basal temporal lobe), lateral temporal lobe, and parietal lobe.Case Study 2 (1page): A 70-year-old male patient presents with his wife, his caretaker. She states that her husband has the following conditions: Afib, diabetes Type 2 (A1C=6.0), Chronic Kidney disease-stage 3, HTN (controlled), hyperlipidemia, benign prostatic hypertrophy, memory loss and obesity. His medication list contains the following: Flomax, lisinopril, amlodipine, atorvastatin, metformin, Trulicity, Coumadin, baby aspirin, multi vitamin with iron, Aricept, and several herbal preparations. A goal for elderly patients is five medications or less. How can you improve this medication regimen? Give rationales for your changes.