A new diagnosis of dementia may be entertained in the emergency department but the decision-making and depth of the workup usually exceeds the time available during the ED stay. A decision to admit or arrange an outpatient diagnostic plan is the usual course in the ED after the differential diagnosis has been considered. Attention should be directed to the possible presence of delirium or a treatable cause of dementia. After investigations have largely excluded any comorbid process acutely worsening symptoms, the patient who is functioning at baseline may be discharged to a safe home environment if caretakers are available. The existence of comorbid medical problems, a rapidly progressive or atypical clinical course, or an unsafe or uncertain home situation should prompt consideration for admission.

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