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Delirium assessment — DGM MCQ

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An 82-year-old man is acutely confused after admission with a chest infection. He alternates between agitation and sleepiness. The nurse reports he cannot recite the months backwards. Current medicines include amoxicillin and prednisolone. What is the most appropriate assessment?

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Correct answer: E — Formal delirium assessment using 4AT or CAM

Acute fluctuating inattention should be assessed with a validated delirium tool such as 4AT or CAM. MMSE alone may miss delirium, EEG is not routine, genetic testing is inappropriate, and memory clinic review should not delay acute assessment. The core cognitive feature of delirium is impaired attention.

Reference: NICE CG103