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Dementia investigations — DGM MCQ

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ModerateDementiaDementia investigationsDGM

A 74-year-old man has six months of cognitive decline and visual hallucinations. He has bradykinesia and fluctuating daytime alertness. Basic blood tests are normal. Current medicines include amlodipine. What is the most appropriate assessment?

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Correct answer: A — Specialist cognitive assessment for dementia subtype

Hallucinations, fluctuations and parkinsonism require specialist cognitive assessment to clarify dementia subtype such as Lewy body dementia. Primary psychosis alone is less likely, haloperidol can be hazardous, normal ageing is not a diagnosis, and waiting for incontinence is inappropriate. Subtype matters because medication risks differ.

Reference: NICE NG97