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Hypoactive delirium — DGM MCQ

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EasyDeliriumHypoactive deliriumDGM

An 86-year-old woman in hospital becomes withdrawn and drowsy over 24 hours. She is usually talkative at home, according to her son. She has inattention, fluctuating alertness and poor oral intake. Current medicines include co-amoxiclav and oxycodone after pneumonia. What is the most likely diagnosis?

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Correct answer: D — Hypoactive delirium

The acute onset, fluctuation and inattention indicate delirium, and reduced activity suggests the hypoactive subtype. Dementia and depression usually evolve over longer periods, normal ageing does not cause acute inattention, and functional cognitive disorder does not fit the systemic illness context. Hypoactive delirium is easily missed because it lacks agitation.

Reference: NICE CG103