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Safeguarding concern in dementia — SCE Geriatric Medicine MCQ

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HardEthics and lawSafeguarding concern in dementiaSCE Geriatric Medicine

An 80-year-old with mild Alzheimer disease develops mild-to-moderate depression after moving home. There is no suicidality, psychosis or previous severe mental illness. Which initial treatment approach is recommended?

Educational content. Not a substitute for clinical judgement or local policy.

Reveal the answer and explanation

Correct answer: B — Offer an adapted psychological treatment rather than routine antidepressant prescribing

Explanation lettering: C = shown as A · D = shown as C · E = shown as D · A = shown as E

B is correct: for mild-to-moderate depression or anxiety in mild-to-moderate dementia, NICE recommends considering psychological treatment and advises against routine antidepressants unless indicated by a pre-existing severe mental health problem. Adaptation for cognition, communication and carer support may be needed. Dementia alone does not lower the drug threshold. Antipsychotic augmentation adds harm without an indication, and cognitive-enhancer escalation is not antidepressant treatment.

Reference: NICE NG97: Dementia assessment and management: https://www.nice.org.uk/guidance/ng97/chapter/Recommendations