You are asked to see an 83 year old woman who is agitated and confused.

Which of the following will be most helpful feature in differentiating delirium from dementia?

Question

You are asked to see an 83 year old woman who is agitated and confused.

Which of the following will be most helpful feature in differentiating delirium from dementia?

BlackTom AI · Accepted Answer

Question restatement: You are asked to see an 83 year old woman who is agitated and confused. Which of the following will be most helpful feature in differentiating delirium from dementia?

Option presented: Acute onset of confusion.

Analysis of the option in context: Delirium characteristically presents with an acute or subacute onset of symptoms, often over hours to days, and is typically accompanied by fluctuating levels of attention and alertness. In contrast, dementia tends to have a gradual, chronic course with a steady decline in cognitive function over months to years. Therefore, an abrupt onset of confusion strongly points toward delirium rather than dementia, and this temporal pattern is among the most helpful discriminators in clinical evaluation.

Consideration of potential nuances: While acute onset is a key differentiator, delirium also commonly features inattention, fluctuating consciousness, and an overall fluctuating mental status. Dementia usually shows a more insidious onset with sustained attention and fluctuating awareness less prominent in early stages. It’s also important to assess reversible contributors to delirium (e.g., infections, medications, metabolic disturbances) since addressing these can rapidly improve the picture.

Limitations due to missing competing options: The provided data includes no other answer choices to contrast with acute onset. In a real exam, other options might include things like a gradual memory loss, stable attention, or a long-standing personality change, which would be less helpful in distinguishing delirium from dementia. The absence of alternative choices here limits a full comparative analysis, but the principle remains that the acute onset criterion is a primary differentiator in favor of delirium.

Summary of reasoning: The abrupt onset of confusion aligns with delirium’s hallmark presentation and contrasts with the typically gradual evolution seen in dementia, making it a highly informative feature for differentiation when evaluating an elderly patient with agitation and confusion.

2025_MEDH_SMP_YEAR_2 KAT 7 Practice Exam 2025

You are asked to see an 83 year old woman who is agitated and confused. Which of the following will be most helpful feature in differentiating delirium from dementia?

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