Diagnostic dilemma: cognitive impairment in the elderly

Cognitive impairment is a significant health problem for the elderly and is associated with severe negative consequences: higher morbidity and mortality and a diminished capacity to care for self. The accurate diagnosis of acute confusion, dementia, and depression depends on the routine, systematic, and comprehensive assessment of cognition, best achieved through the use of a mental status questionnaire and a behavioral rating scale. Nonspecific clinical features, atypical and variable presentations of symptomatology, and the frequent coexistence of acute confusion, dementia, and depression make an accurate diagnosis of the specific form of cognitive impairment difficult. The primary cognition disorder in acute confusion is that of attention, memory with dementia, and mood with depression.