Falls prevention — SCE Geriatric Medicine MCQ
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Correct answer: B — Use a personalised programme of sleep hygiene, daylight, exercise and meaningful activity
Explanation lettering: B = shown as A · A = shown as B · E = shown as C · C = shown as E
A is correct: NICE advises a personalised multicomponent approach incorporating sleep hygiene, daylight exposure, exercise and tailored activities for sleep problems in dementia, after remediable causes are addressed. It specifically advises against melatonin for insomnia in Alzheimer disease. Long-term hypnotic treatment adds falls, cognitive and dependence harms. Increasing or moving donepezil to bedtime can worsen vivid dreams or insomnia and is not a sleep-management strategy.
Reference: NICE NG97: Dementia assessment and management: https://www.nice.org.uk/guidance/ng97/chapter/Recommendations