To the Editor: One of the main problems that physicians encounter when a patient with delirium is admitted to a hospital, is to assess the degree of cognitive impairment present before the acute clinical event that caused hospi-talization. This is important because dementia is both a risk factor for delirium and a strong prognostic modulator of the patient's global health status and survival.As highlighted in the Rational Clinical Examination article by Dr Wong and colleagues,3 physicians often fail to recognize delirium and therefore they may underdiagnose it. However, the risk of underdiagnosing delirium when it is superimposed on dementia is also relevant.
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