I agree with your diagnosis code. You could explain code selection by saying manifestations visualized on MRI technique were decline in brain volume due to etiological small vessel deep white matter arteriosclerotic changes which over time led to decreased brain volume.
There for in a scenario were you can identify the manifestation (confusion) integral into the manifestation-etiology(decline in brain volume) which can integrate into the etiology(arteriosclerotic changes) we come to the most robust condition leading to the cause of shrinking of brain tissue which is arteriosclerosis.
Manifestation - Manifestation/etiology = etiology = robust condition to code
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