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Delirium vs dementia — DGM MCQ

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EasyDeliriumDelirium vs dementiaDGM

An 81-year-old woman is brought by her son because she has become confused since yesterday. She misidentifies relatives and is worse at night. She had been managing bills independently last week. Current medicines include amlodipine and atorvastatin. What is the most appropriate assessment?

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Correct answer: C — Assess for delirium and search for an acute cause

Acute change over one day with fluctuation strongly suggests delirium, so the priority is assessment for acute precipitants. Alzheimer's disease and driving assessment are not first-line in an acute confusional state, donepezil is inappropriate acutely, and normal ageing does not cause sudden confusion. Collateral history about baseline function is central to distinguishing delirium from dementia.

Reference: NICE CG103