Your patient is a 77-year-old woman who has been more socially withdrawn lately and told her daughter she had not been feeling well. While shopping for groceries with her daughter she became separated from daughter in the aisles. She became confused and angry when store employees and others tried to assist her. It is now 30 minutes later.
What is your differential diagnosis based on the information you now have?
What other questions would you like to ask her now? (Questions can be asked of patient first, and then of reliable historian separately.)
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Based on above information, the patient is more likely to be diagnosed with dementia. It is related to the decline in normal cognitive ability and may be chronic and progressive. Generally, confusion in the elderly patient is a symptom of delirium or dementia, but it may also occur in major depression and psychoses (American Psychiatric Association, 1997).
The physician should pay close attention to the patient behavior, as well as the patient's functional status.
The following questions should be considered (Ham RJ, 1997):...
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