— 心理社會完整性 · MEDIUM · SATA —
老年個案出現下列哪些徵象時，可能提示為瞻妄而非失智症？（選所有適合的）
Which of the following signs in an elderly client may indicate the presence of delirium rather than dementia? (Select all that apply.)
- ARapid onset of symptoms over hours or days✓ 正解症狀在數小時或數天內快速發作
- BFluctuating level of consciousness✓ 正解意識水平波動
- CSymptoms that worsen in the evening (sundowning)傍晚時症狀惡化（日落現象）
- DDisorganized thinking and impaired attention✓ 正解思維混亂及注意力受損
- EChronic and irreversible memory loss慢性且不可逆的記憶喪失
— Explanation · 中文詳解 —
瞻妄（Delirium）特徵為急性發作、意識狀態波動及注意力受損，通常可逆；失智症則為慢性、緩慢退化。選項 C 雖常見於失智症（日落症候群），亦可能發生在瞻妄個案，但非鑑別診斷的核心依據；E 選項為失智症特徵，非瞻妄特徵。
Delirium is characterized by acute onset, fluctuating level of consciousness, and impaired attention, and it is usually reversible; dementia, in contrast, is chronic with slow, progressive decline. Option C (sundowning), while commonly seen in dementia, can also occur in delirium and is therefore not a core distinguishing feature. Option E describes the hallmark of dementia rather than delirium.
✦ 台美臨床差異
美國推行 CAM（Confusion Assessment Method）量表評估瞻妄；台灣臨床較多使用簡短智能評估（MMSE）區辨失智，瞻妄則仰賴醫師評估。