Understanding Delirium vs. Dementia

Although delirium and dementia can manifest with similar symptoms, they are two distinct conditions. Because a person can suffer from both dementia and delirium, it is important to understand their similarities and differences.

Delirium involves sudden, severe confusion with abrupt brain function changes. Delirium typically appears within a few hours to a few days, and symptoms come and go and are usually reversible. Delirium is most often traced to a physical or mental illness such as infections (e.g., pneumonia or urinary tract infections), or electrolyte and body chemical imbalances. Surgery, medication, poisons, and alcohol or drug abuse also can bring on the rapid delirium symptoms that may include:

  • Changes in level of awareness, alertness or consciousness
  • Extreme personality and emotional changes (agitation, anxiety or depression)
  • Disorganized and unclear thinking
  • Difficulty speaking or rambling in speech
  • Decreased short-term memory and recall
  • Changes in sensation and perception
  • Altered movement (either slow or hyperactive)
  • Disturbed sleep patterns

Dementia is the progressive decline of brain function that occurs with certain diseases, most commonly Alzheimer’s. Most types of dementia are degenerative and cannot be stopped. Underlying medical conditions can lead to dementia including strokes, multiple sclerosis and Parkinson’s disease. The memory, language and cognitive impairment with dementia are gradual over time, compared to the quick onset and more erratic fluctuations with delirium.

Delirium is commonly mistaken for dementia, depression or the aging process. Seniors recovering in a hospital or care facility are more susceptible to delirium. Treatment for either delirium or dementia depends on the root cause of the symptoms. Delirium may resolve simply by stopping or changing medications, and certain mental exercises can help dementia. If you notice signs of delirium or dementia in a loved one or yourself, see a doctor.

How can you keep a delirious person safe when he/she is confused?

9 Comments

  1. Dr. Jeff Weishaar March 14, 2012 12:57 PM

    One of the real issues involved with this topic is the quick identification of the delirium. The early signs of delirium are often subtle and ignored. When an individual, especially an elderly individual with a recent hospitalization, previous delirium, pre-existing dementia and multiple chronic health issues, demonstrates mild disorientation, this must be evaluated. I encourage all health workers to take the time to ask open-ended questions about what is said that would indicate a disturbance in consciousness/orientation. Even if 80% of what they say is spot on, but they also said they are looking forward to moving back home with their parents (who, of course, are deceased), then appropriate steps must be taken to rule out delirium. This means immediately contacting the physician to obtain orders for labs to be drawn. Of course, evaluate for uncontrolled pain, constipation, medication side effects, malnutrition and dehydration.

  2. Rita Ude March 15, 2012 09:08 AM

    Thank you for your comments, Dr. Weishaar. We appreciate your medical expertise on this subject. Check back with us often to read more blogs on home care for seniors and disabled people.

  3. Stephanie Nehring March 15, 2012 01:57 PM

    I receive admissions from the hospital into SAR with families so upset because their loved one has been diagnosed with dementia and started on medications. After speaking with the patient and family and often hospital caregivers I find that their symptons are delerium. It happens so often.

  4. Stephanie Nehring March 15, 2012 01:57 PM

    I receive admissions from the hospital into SAR with families so upset because their loved one has been diagnosed with dementia and started on medications. After speaking with the patient and family and often hospital caregivers I find that their symptons are delirium. It happens so often.

  5. Rita Ude March 15, 2012 04:52 PM

    Thanks for your comments, Stephanie. Delirium and dementia often are confused, so we hope this blog will help clarify the two conditions.

  6. Peter April 22, 2012 12:16 PM

    I'm glad that you mentioned how surgery and medications can cause the onset of delerium. Proper treatment is certainly important, but overtreatment and overmedication can actually cause symptoms to worsen. I think that hospitilization should be a last resort, and that people suffering from both dementia and delerium ought to receive as much care in their homes as possible. Living happy, familiar, day-to-day lives is what keeps symptoms from progressing too rapidly.

  7. Mickey Marrero-Bruno May 15, 2012 09:48 PM

    I have been a caregiver for 5 years now & yes I've had the experience with my patients ... I see some related things in the baseline dementia, but I always go into the mental exercises with them and we start a conversation & I do my observations ASAP, and of course ask the questions. I have seen the difference in both dementia & delirium. It's great to read and learn from the experts and always, always be attentive to the ones you care for, at home, or in a hospital, or an assisted living facility & nursing homes. I love my job & love helping others. I'm always learning and taking courses for new things within the health industry. Thank you.

  8. Mickey Marrero-Bruno May 15, 2012 09:48 PM
    I have been a care giver for 5 yrs now & yes I've had the experience with my patience... I see some related things in the baseline dementia, but I always go into the mental exercises with him and we start a conversation & i do my observations ASAP, and of course ask the questions, I have seen the difference in both D & Dil.. It's great to read and learn from the experts and always, always be attentive to the ones u care for, at home, or in hosp, or ALF & nursing homes. I love my job & love helping others, I'm always learning and taking courses for new things within the Health Inds. Thank you...
  9. Rita Ude May 16, 2012 02:23 PM

    Thank you for your comments! We appreciate you reading our blog and hope that the information we provide will help you as you provide care for your patients. It is always great and fulfilling to learn new things!

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