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Delirium Risk Factors — MRCPsych Paper B MCQ

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EasyOld Age PsychiatryDelirium Risk FactorsMRCPsych Paper B

According to NICE CG103, which option lists the factors that should be assessed when an adult first presents to hospital or long-term care to determine whether they are at risk of delirium?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Age 65 years or older, cognitive impairment and/or dementia, current hip fracture, and severe illness

Explanation lettering: E = shown as C · C = shown as E

B is correct. NICE CG103 recommends assessing four specified factors at initial presentation to hospital or long-term care: age 65 years or older, past or present cognitive impairment and/or dementia, current hip fracture, and severe illness defined as a condition that is deteriorating or at risk of deterioration. The original option incorrectly added sensory impairment to this formal list. Sensory impairment, dehydration, constipation and sleep disturbance are clinically relevant and are addressed within NICE's multicomponent delirium-prevention interventions, but they are not the four factors listed in recommendation 1.2.1. Depression, polypharmacy, previous delirium, male sex and cardiometabolic conditions are likewise not included in that specified NICE assessment list.

Reference: National Institute for Health and Care Excellence. Delirium: prevention, diagnosis and management in hospital and long-term care (CG103), section 1.2, recommendation 1.2.1. Published 2010; updated 2023. https://www.nice.org.uk/guidance/cg103/chapter/Recommendations