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Depression mimicking dementia — DGM MCQ

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ModerateDementiaDepression mimicking dementiaDGM

A 79-year-old woman is referred with memory concerns after bereavement. She reports low mood, early morning wakening and poor appetite. She often answers I don't know but performs better with encouragement. Current medicines include amlodipine. What is the most likely diagnosis?

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Correct answer: E — Depression with cognitive symptoms

Low mood, biological depressive symptoms and variable effort suggest depression with cognitive symptoms rather than primary dementia. Alzheimer's disease is more steadily progressive, delirium is acute and fluctuating, Lewy body dementia has hallucinations and parkinsonism, and normal pressure hydrocephalus has gait and urinary features. Mood assessment is part of cognitive assessment in older adults.

Reference: NICE depression guidance; NICE NG97