Delirium vs Dementia: What is The Difference? (2023)

If you are providing care for a loved one and begin to observe changes in their mental condition, such as a deterioration in memory or disorientation, your initial impression might be that dementia is the cause of these symptoms.

However, delirium is another possibility of the cause of the problem. As these two illnesses have numerous similar symptoms, distinguishing one from the other can be challenging.

Dementia and delirium both impair a person’s capacity for rational thought and their ability to look after themselves. They do exhibit certain indications and symptoms that are comparable to one another. However, each condition’s causes and treatments, are distinct.

The condition known as delirium is considered a medical emergency and needs to be treated right away. On the other hand, it is frequently confused with dementia. This is because both of these illnesses can manifest simultaneously in certain people.

Discover the differences between the two and what you could do to assist a person who exhibits symptoms of one or both conditions.

Delirium

Delirium, also known as acute confusion, is a significant and acute medical illness in which a person’s mental ability is compromised directly due to the condition. It manifests within a relatively short period (often within hours or days), and symptoms tend to fluctuate throughout the day.

It is a disorder that frequently occurs in elderly patients who are hospitalized, but it is also possible, albeit less frequently, for it to manifest in people who are not confined to a healthcare facility. There is a possibility that delirium can be avoided in up to two-thirds of hospitalized patients, and even if it does occur, it is frequently treated.

Distress is caused by delirium for the individual experiencing it, their relatives, and the medical professionals treating them.

(Video) The Clinical Differences Between Depression, Delirium, and Dementia

Dementia

A person is said to have dementia if they exhibit a spectrum of symptoms that indicate their brain is losing function. Over time, a person who has dementia will have a diminished capacity for thinking, remembering, and communicating with others. This condition gets progressively worse over time.

After some time has passed, people will have difficulty carrying out routine activities and following directions. In addition, the individual will have difficulty communicating with and comprehending other people. For example, a person who has dementia may, over time, forget who people are, and have trouble remembering where they are.

Differences Between Delirium And Dementia

1. The Time Frame And Reversibility

With dementia, there is no treatment or cure. One notable case in point is Alzheimer’s disease, which is the most prevalent kind of dementia.

On the contrary, delirium is not a persistent condition. In point of fact, when someone’s confusion is caused by delirium, the disorientation itself will typically reduce and go entirely in the days and weeks after the diagnosis of the condition.

There will always be exceptions, but in most cases, a person’s mental condition will recover to where it was before they entered delirium. In contrast to dementia, delirium may be treated and hence has a shorter duration of symptoms.

2. The Initial Signs And Symptoms

Even while dementia and delirium share signs of confusion, the specific symptoms of each condition are distinct. Dementia progresses gradually over the course of several years.

On the other hand, delirium manifests itself suddenly within a few hours or a few days at the most. In cases of dementia, it is sometimes difficult to pinpoint the exact moment when the confusion first emerged, but in cases of delirium, it is frequently easy to do so.

It is important to be aware that the individual’s level of confusion in delirium is more likely to fluctuate than it is in dementia. A person with delirium may experience significant improvement or worse over a single day or even in the course of a few hours. Cognitive fluctuations are the term used to describe these occurrences.

(Video) What is the difference between Delirium and Dementia? | Delirium vs Dementia Mnemonic OCD CAMPS

Although cognitive fluctuations can still be be present in dementia, they more commonly develop over the course of a longer length of time.

3. The Underlying Causes And Contributing Factors

It seems to be the reason that the causes of dementia and delirium are distinct, given that dementia develops gradually whereas delirium comes on quickly. There is still no conclusive evidence to support a single factor that brings on delirium.

Medical research has discovered that delirium can be caused by a combination of several factors. These can include some of the following: infection, poor nutrition, isolation, age, medications, impaired vision and hearing, a high burden of medical diseases, dehydration, and dementia. Having dementia raises the likelihood of experiencing an episode of delirium in addition to dementia.

Regardless of whether dementia exists or not, delirium can only arise in the presence of specific triggers. These include any occurrences that generate considerable strain, such as infections, falls, surgery, being admitted to the hospital, or prescription mistakes, for example.

These particular causes can bring on delirium, but they cannot bring on dementia.

4. The Treatment Strategies

Managing Both the symptoms of delirium and dementia are treatable, although each treatment is different. The objective of managing the symptoms of dementia is to help manage the symptoms that interfere with everyday life, but dementia is progressive, meaning it will get worse over time despite the medication options available.

Unfortunately, even while there are medications available to help manage the symptoms dementia, none of them can actually cure dementia.

When delirium is present, the confused condition can be totally reversed. Therefore, certain medications are only used for intermittent periods of time and on an as-needed basis.

However, the primary focus of treatment is to identify and address the underlying causes of delirium in order to alleviate its symptoms. After the triggering factor has been eradicated, the brain will heal on its own, and the confusion will begin to go away.

(Video) How to know the difference between dementia and delirium

What Can You do to Assist Older People Who Are Confused?

Delirium vs Dementia: What is The Difference? (2)

If you are concerned about the mental condition of a loved one and have noticed that they appear confused, talk to their physician. It is crucial to be aware that delirium nearly often implies a severe medical problem that requires prompt medical attention.

1. Maintain Your Connection

Maintain a consistent line of communication with the member of your family or close friend whom you care for. If you do not live close to them, you can consider the use of techology to keep in contact with them and keep an eye on their health and wellness.

2. Pay Close Attention to The Various Changes

Nobody knows your friend or family member as well as you do. Your loved one will be able to receive the treatment and care they require as quickly as possible if you pay attention to small changes in their condition that the attending physician or hospital personnel may overlook.

3. Speak Up

Does the person you love appear overly reserved and far away? Do they appear to be puzzled and lost in their surroundings? Notify the doctor if you see that they are not acting like themselves completely.

4. Seek Emergency Medical Attention

If you observe any sudden shifts in the mental state or the behavior of a senior loved one, you should seek emergency medical assistance.

5. Discuss Unexpected Symptoms

Talk to your doctor about any strange symptoms or behaviors you’ve been experiencing, even if you’re not sure if there’s a connection between the two. Always remember to carry a list of all of your loved one’s prescriptions with you to appointments.

6. Help Them While They Recover

Even though the symptoms of delirium are often very transient, it may take a little time for people to recover from an episode of delirium after having one fully.

Be ready to assist your loved one with day-to-day tasks during this period, or look into other care choices, including a short-term respite care stay at an assisted care center, which may assist with things like meals, dressing, bathing, and managing medications, among other things.

(Video) DELIRIUM OR DEMENTIA: KNOW THE DIFFERENCE

Delirium Among Those Affected by Dementia

Delirium is different from dementia, but some of the symptoms can be similar. People of a certain age may experience either one of them independently or both at the same time.

The existence of dementia makes it more likely that delirium will develop in the affected individual’s brain. Delirium is roughly five times more likely to occur in people who have dementia, regardless of whether or not dementia has been identified.

Even though the duration and pattern of symptoms are different for each condition, delirium and dementia share a number of signs in common. As a consequence of this, delirium may pass unnoticed, even by those who work in the medical field.

It’s imporant to discuss and new onset of symptoms with a healthcare provider. When the signs of delirium are incorrectly attributed to dementia that has not been properly identified, this can have catastrophic effects and postpone the treatment of the real diagnosis. After many weeks, patients who have been mistakenly diagnosed with dementia may appear to be in a nearly normal state.

In most cases, the sudden onset of symptoms and variation in delirium help in the classification process. Additionally, the input from family members or other significant people is essential in order to differentiate delirium from underlying dementia.

There is some evidence to show that delirium may speed up the cognitive decline that is already present in patients who have dementia. People in the final stages of dementia typically exhibit symptoms comparable to those of delirium. In addition, those who have Lewy body disease are more likely to suffer from delirium, which is distinct from a simple worsening of the symptoms of Lewy body disease.

To Wrap Up

An abrupt change in state is one of the defining features of delirium, which is why it has to be handled as a medical emergency.

The effects of delirium may persist anywhere from a few days up to a couple of months and can typically be treated. On the other hand, dementia is a progressive condition that results in brain cell death, and this is irreversible.

In many different ways, delirium has been related to dementia. The two conditions are, in fact, extremely interwoven with one another. For example, following an episode of delirium, a person with dementia may have a discernible worsening of their symptoms.

(Video) DELIRIUM V. DEMENTIA | NCLEX REVIEW

There are cases in which an older person does not have a dementia diagnosis prior to suffering delirium but may obtain one shortly afterward. According to the Alzheimer’s Society, this phenomenon is referred to as delirium “uncovering” dementia in the patient.

You, as a caregiver, know your loved one better than anybody else. If you notice a rapid change in the person’s demeanor or the appearance of a new symptoms, make sure to inform the attending physician of any symptoms of delirium. This is crucial so the physican can further address in order to come up with an appropriate individualized treatment plan.

References

FAQs

Why is it important to differentiate delirium and dementia? ›

Differentiating delirium and dementia is critically important and can be challenging in many cases. Delirium is a common occurrence in elderly patients and is often overlooked in the elderly due to concurrent history of dementia. The two are distinct pathologic processes with different management and prognoses.

What are the 3 types of delirium? ›

Types of delirium
  • Hyperactive delirium. This may be the easiest type to recognize. People with this type may be restless and pace the room. ...
  • Hypoactive delirium. People with this type may be inactive or have reduced activity. They tend to be sluggish or drowsy. ...
  • Mixed delirium. Symptoms involve both types of delirium.
14 Oct 2022

What are 3 causes of delirium? ›

What causes delirium?
  • Alcohol or drugs, either from intoxication or withdrawal. ...
  • Dehydration and electrolyte imbalances.
  • Dementia.
  • Hospitalization, especially in intensive care.
  • Infections, such as urinary tract infections, pneumonia, and the flu.
  • Medicines. ...
  • Metabolic disorders.
  • Organ failure, such as kidney or liver failure.
16 Jun 2021

What are the key signs of delirium? ›

All types of delirium can include the following symptoms:
  • confusion or disorientation.
  • memory loss.
  • slurred speech or difficulty speaking coherently.
  • difficulty concentrating.
  • hallucinations.
  • changes in sleep patterns.
  • changes in mood or personality.
15 Oct 2019

What is worse delirium or dementia? ›

Delirium is typically caused by acute illness or drug toxicity (sometimes life threatening) and is often reversible. Dementia is typically caused by anatomic changes in the brain, has slower onset, and is generally irreversible.

Can delirium be mistaken for dementia? ›

Delirium is a sudden change in a person's mental state. It is a serious condition that is sometimes mistaken for dementia or, more rarely, depression. Unlike dementia, delirium develops quickly and is usually temporary.

What is the number one cause of delirium? ›

It is not clear why or how delirium develops. There are many potential causes, with the most common including infections, medications, and organ failure (such as severe lung or liver disease). The underlying infection or condition is not necessarily a brain problem.

How does a person with delirium act? ›

Delirium happens when a person has sudden confusion or a sudden change in mental status. The person may have trouble paying attention or thinking clearly. They may act disoriented or distracted.

What medications can cause delirium? ›

Observational studies show that the most common drugs associated with delirium are sedative hypnotics (benzodiazepines), analgesics (narcotics), and medications with an anticholinergic effect. Other medications in toxic doses can also cause delirium.

Can people recover delirium? ›

Delirium is temporary and usually improves shortly after the cause is treated, but for some people it takes several weeks to resolve and might continue when you have been discharged from hospital.

How do you fix delirium? ›

Treatment
  1. Protect the airway.
  2. Provide fluids and nutrition.
  3. Assist with movement.
  4. Treat pain.
  5. Address a lack of bladder control.
  6. Avoid the use of physical restraints and bladder tubes.
  7. Avoid changes in surroundings and caregivers when possible.
  8. Include family members or familiar people in care.
14 Oct 2022

What is the treatment for delirium? ›

What is treatment and support for delirium? Delirium is treated first by addressing the medical problem(s) that have caused it. For example, if the person has low blood oxygen or low blood sugar levels these will be corrected quickly. If the person has an infection they may be given antibiotics.

What is the test for delirium? ›

BEST TOOL: The Confusion Assessment Method (CAM) is a standardized evidence-based tool that enables non-psychiatrically trained clinicians to identify and recognize delirium quickly and accurately in both clinical and research settings.

What does end of life delirium look like? ›

Terminal delirium symptoms may include agitation, somnolence, memory disturbance, thinking difficulty, communication difficulty, disorientation, irrelevant/incoherent speech, hallucinations, delusions, physical restlessness, inappropriate behavior, and mood lability.

What is the most common cause of delirium at the end of life? ›

Medications are one of the most common causes of delirium, including opioids, anti-seizure drugs, steroids, and anxiolytics. Overuse of medications can cause toxicity and under-use can cause pain and discomfort, all which can further worsen delirium.

Is delirium a cause of death? ›

Delirium is highly distressing for patients and their carers and is known to be linked to long-term cognitive impairment and increased risk of death.

Do delirium patients remember? ›

It is often said that the majority of patients with delirium are unable to remember the episode, but empirical evidence for this conclusion seems lacking. Indeed, Wolff & Curran (Reference Wolff and Curran1935) suggested (p. 1213) that “Recall is usually good”.

Does delirium go away in the elderly? ›

It can take older adults a long time to fully recover from delirium. Most people are noticeably better within a few days, once the delirium triggers have been addressed. But it can take weeks, or even months, for some aging adults to fully recover.

Can delirium speed up dementia? ›

Evidence suggests that delirium may hasten cognitive deterioration in people with pre-existing dementia. In later stages of dementia, people frequently develop symptoms similar to a delirium. Additionally, delirium is more common in those with Lewy body disease and is not just a worsening of Lewy body disease symptoms.

Can a brain scan detect delirium? ›

Conclusion: In this limited study, patients with delirium were noted to be more likely to have had a CT scan. Older patients with delirium had a variety of findings on brain imaging, some of which were more clinically relevant. No specific imaging changes were diagnostic for delirium.

Is delirium temporary or permanent? ›

Delirium is most often caused by physical or mental illness and is usually temporary and reversible. Many disorders cause delirium. Often, these do not allow the brain to get oxygen or other substances.

How long can you live with delirium? ›

Delirium has a poor prognosis, regardless of how well it is identified, investigated and treated, especially the hypoactive (drowsy) form. Half of those with delirium on general and geriatric medical wards will die within six months.

How do you talk to someone with delirium? ›

Stay calm; talk to them in short, simple sentences and check that they have understood you, repeating things if necessary. Remind them of what is happening and reassure them about how they are doing. Having someone around that they know well, or even some familiar objects from home, can really help.

What happens to the brain with delirium? ›

Delirium is a sudden, fluctuating, and usually reversible disturbance of mental function. It is characterized by an inability to pay attention, disorientation, an inability to think clearly, and fluctuations in the level of alertness (consciousness). Many disorders, drugs, and poisons cause delirium.

Should someone with delirium go to hospital? ›

If someone suddenly becomes confused, they need to see a doctor urgently. The person with delirium may be too confused to describe what has happened to them, so it's important that the doctor can talk to someone who knows the patient well. To treat delirium, you need to treat the cause.

What is the first line treatment for delirium? ›

Antipsychotics are commonly used as first-line medication in order to confront these situations, although the evidence for their use to treat delirium in non-ICU or ICU settings is limited [1, 2].

Can delirium come on suddenly? ›

Sudden confusion (delirium) describes a state of sudden confusion and changes in a person's behaviour and alertness. If the confusion has come on suddenly, you should take the person to your nearest hospital or call 999 for an ambulance.

Can stress bring on delirium? ›

Severe anxiety can disrupt neurohumoral metabolism and lead to agitation and brain failure, which may result in delirium.

What happens if delirium goes untreated? ›

It also leads to complications, such as pneumonia or blood clots that weaken patients and increase the chances that they will die within a year. “Delirium is an emergency. It is a serious medical problem,” says Dr.

Can delirium be serious? ›

Delirium is a serious condition where the person experiences a disturbance in attention, perception, awareness and cognition. Delirium may be caused by general medical conditions (for example, infections, hypoxia), certain medications, intoxicating substances or a combination of these.

How do hospitals deal with delirium? ›

After medical issues are addressed, the same strategies used to prevent delirium are used to treat it: working to ensure patients maintain an appropriate sleep/wake cycle, minimizing disruptions during nighttime hours, and making sure patients have access to eyeglasses, hearing aids, and dentures to prevent ...

What is the best medication for delirium? ›

Although haloperidol is considered as the most preferred agent in the management of delirium, but if elderly patients with Parkinson's disease or Lewy Body Dementia, develop delirium, atypical antipsychotics are considered as the preferred agents by a few authors.

What hospice does not tell you? ›

Hospice providers are very honest and open, but hospice cannot tell you when the patient will die. This is not because they don't want to, it's because they can't always determine it.

What are the first signs of end of life? ›

End-of-Life Signs: The Final Days and Hours
  • Breathing difficulties. Patients may go long periods without breathing, followed by quick breaths. ...
  • Drop in body temperature and blood pressure. ...
  • Less desire for food or drink. ...
  • Changes in sleeping patterns. ...
  • Confusion or withdraw.

How do you calm someone with delirium? ›

How to Help a Person with Delirium
  1. Encouraging them to rest and sleep.
  2. Keeping their room quiet and calm.
  3. Making sure they're comfortable.
  4. Encouraging them to get up and sit in a chair during the day.
  5. Encouraging them to work with a physical or occupational therapist. ...
  6. Helping them eat and drink.
3 Jan 2019

Why is it important for nurses and clinicians to understand the differences between delirium dementia and depression? ›

Home healthcare clinicians need to understand symptoms of each of these conditions and remain astute in their assessment of these distinctly different entities. Failure to correctly identify delirium, dementia, and/or depression can delay treatment and result in poor quality of life.

Why is it important to identify delirium early? ›

If delirium still occurs, then identify it as soon as possible and treat it as best you can. Cognitive screening, on admission to hospital and routinely throughout the stay, provides a baseline to identify a decline in a person's cognition that may be due to delirium, dementia or depression.

Which is the most important feature that separates delirium from dementia? ›

Delirium occurs abruptly, and symptoms can fluctuate during the day. The hallmark separating delirium from underlying dementia is inattention.

Why is delirium identification important? ›

It's really important that a person's delirium is diagnosed quickly. Delirium is a serious condition and is linked to severe problems if it isn't treated. A healthcare professional such as a doctor or nurse will make the diagnosis.

How do you diagnose dementia and delirium? ›

No laboratory test can definitively establish the cause of cognitive impairment; a thorough history and physical examination as well as knowledge of baseline function are essential.

What is the most helpful treatment for delirium? ›

A healthcare provider may prescribe antipsychotic drugs, which treat agitation and hallucinations and improve sensory issues. Antipsychotic drugs include: Haloperidol (Haldol®). Risperidone (Risperdal®).

What is the gold standard for diagnosing delirium? ›

Confusion Assessment Method (CAM-long)

The Confusion Assessment Method is a 10-item tool that is the gold standard for delirium identification including diagnosis, severity, and behavioral subtype.

What procedure confirms delirium? ›

Physical and neurological exams.

A neurological exam checks vision, balance, coordination and reflexes. This can help determine if a stroke or another disease is causing the delirium.

Does delirium show up on a brain scan? ›

Conclusion: In this limited study, patients with delirium were noted to be more likely to have had a CT scan. Older patients with delirium had a variety of findings on brain imaging, some of which were more clinically relevant.

What is the drug of choice in delirium? ›

Medication use in delirium

Haloperidol is the drug of choice, as it has the least side effects for short term use in delirious patients. Haloperidol has low anticholinergic effect and is used for a brief period for most cases of delirium.

What is the most common cause of delirium in the elderly? ›

Among elderly patients, dementia is the most prominent risk factor, being present in up to two-thirds of all cases of delirium.

Should you be in hospital with delirium? ›

If someone develops hospital delirium, stay with him or her in the hospital as much as possible, including at night. In addition to providing comfort and reassurance, family members are more likely than others to recognize when their loved one isn't behaving normally or being treated appropriately.

Does delirium need to be treated in hospital? ›

Depending on how bad the delirium is, a person may need to go into hospital for treatment and management. For others, delirium can be treated at home. Delirium can be a frightening condition for those who have it, together with their family and carers.

Videos

1. 223 - Delirium and Dementia - USMLE STEP 1 - PRESENTED BY USMLE ACE
(USMLE ACE INC)
2. Delirium vs Dementia: What is the difference?
(Med Shots by Dr. Narula)
3. Delirium Vs Dementia
(Faculty Of Medicine)
4. Delirium - causes, symptoms, diagnosis, treatment & pathology
(Osmosis)
5. Evaluating the Difference between Delirium, Depression and Dementia
(Social and Behavioral Sciences at Bethel Univ.)
6. Dementia VS Delirium for HESI, ATI, and NCLEX
(Nexus Nursing)
Top Articles
Latest Posts
Article information

Author: Rev. Porsche Oberbrunner

Last Updated: 01/11/2023

Views: 6115

Rating: 4.2 / 5 (53 voted)

Reviews: 92% of readers found this page helpful

Author information

Name: Rev. Porsche Oberbrunner

Birthday: 1994-06-25

Address: Suite 153 582 Lubowitz Walks, Port Alfredoborough, IN 72879-2838

Phone: +128413562823324

Job: IT Strategist

Hobby: Video gaming, Basketball, Web surfing, Book restoration, Jogging, Shooting, Fishing

Introduction: My name is Rev. Porsche Oberbrunner, I am a zany, graceful, talented, witty, determined, shiny, enchanting person who loves writing and wants to share my knowledge and understanding with you.