4th September 2020

An 82-year-old man is brought by an ambulance to A&E

An 82-year-old man is brought by an ambulance to A&E. He lives in a residential home, as he requires assistance with activities of daily living, such as meal times and bathing. This evening he became agitated and aggressive towards other residents, behaviour which is very out of character for him. His past medical history includes ischaemic heart disease, atrial fibrillation, hypertension, gout and osteoarthritis. The care home staff report he was incontinent of urine just before the paramedics arrived, which is unusual for him. On assessment, the patient tells you to leave him alone, and states that he “has no idea where I am but I want to go home”. He has no prior diagnosis of cognitive impairment.

For the case above, please select the SINGLE most likely diagnosis. Select ONE option from the list above.