Dementia and Delirium are perplexing conditions both to differentiate and experience. Dementia is a progressive intellectual function and other cognitive skills decline condition, which results to a decline in an individual’s performance of their daily activities. Unlike dementia, delirium also known as acute confusional state is an acute medical condition which results in confusion and other disruptions in how a person thinks and behaves including attention, activity level and perception. It is very important to distinguish between the two conditions because, delirium can be found in a person that already has dementia. A study done by Fick and Mion (2008) indicated that, about 22% of adults with dementia develop delirium. Therefore, people with dementia can also be affected by delirium.
Dementia and delirium can cause impaired functioning, memory loss, poor judgment and a problem in speech; however, there are many differences between the two. Even though delirium and dementia can manifest with similar symptoms, they are two different conditions (Ajilore and Kumar, 2004). This is because, an individual can suffer from both delirium and dementia and therefore, it is very vital to differentiate between the two. In addition, delirium is reversible while dementia is a permanent condition. Therefore, differentiating the two will help in the quick treatment of delirium.
The causes of the two conditions are similar in one way or another at the same time they vary. Delirium is caused by acute illness or drug toxicity while dementia is caused by specific illnesses and anatomic changes in the brain that are generally irreversible. Dementia is a condition caused by Alzheimer’s disease, lewy body dementia, vascular dementia prontotemporal dementia and other related disease. It can also be caused by emotional illnesses, metabolic disorders, trauma, drugs and alcoholism. Unlike dementia, delirium is a disease triggered by specific illnesses for instance pneumonia, a brain event such as stroke, dehydration, and urinary tract. It can also be caused by under nutrition, infections, emotional distress, and illegal use of drugs. Delirium is an acute temporary condition and, if its cause is identified and treated, it only lasts for a couple of months or days. On the other hand, dementia is a chronic, insidious and progressive condition that is incurable; however, some dementia causes such as hydrocephalus and normal pressure are reversible. In addition, the communication abilities of the two conditions vary. In dementia, individuals experience the difficulty of finding the right words during communication. Moreover, the ability to express themselves deteriorates gradually as the disease progresses. Conversely, delirium can notably impair a person’s ability to communicate coherently.
In delirium, the changes in intellect and memory are more abrupt while in dementia, the changes are slow and are gradually noticed after months or years. The changes in delirium are sudden and cause severe confusion of the brain with unclear and disorganized thinking. In dementia, an individual’s alertness level is typically not affected until the late stages of Alzheimer’s disease. Dementia patients are always alert, and aware to their surroundings (Arnold, 2004). Also, the person’s memory is always affected throughout the disease. Comparably, in delirium, the opposite is true as an individual’s memory is less affected, and his/her alertness is impaired. A person with delirium has difficulties in maintaining attention to something, or even focusing on something, since their consciousness is impaired. Individuals with these diseases perceive things differently. The perception of a person with delirium is distorted and hallucinated and this brings difficulties in distinguishing reality from delusions. On the other hand, a person with dementia has a normal perception.
The activity level in patients with the two conditions differs. Individuals with delirium are always either hyper-active and restless, or under-active and less responsive compared to their usual functioning. Comparably, dementia does not affect an individual’s activity level, until the later stages of the condition (Arnold, 2004). However in the later stages, an individual becomes impaired as he/she is unable to even perform simple daily activities like eating, walking, bathing and even dressing. Their emotions are similar, for instance irritable and aggressive, however, a person with delirium is fearful because of their aggressiveness and an individual with dementia is lethargic and labile. According to Arnold (2004), patients with dementia may become anxious, irritable, self-centered and get angry very easily. At times, they become more passive, and have a tendency of general withdrawal from social situations. Patients with delirium have disturbed and disrupted sleep patterns due to extreme emotional changes, and personality that causes depression and anxiety. On the other hand, an individual with dementia has fragmented sleep patterns.
In conclusion, as population ages, dementia and delirium are increasingly important medical conditions. The two conditions coexist and this complicates the differential diagnosis in patients with cognitive impairment. Patients with cognitive dysfunction should sort out potential causes of their impairment because; dementia and delirium exhibit similar symptoms and therefore, require distinct treatment strategies. Dementia and delirium are characterized by cognitive decline whereby the brain function changes. The brain functions of people with dementia and delirium are affected making them not to function normally like any other person. They both affect an individual’s attention, thinking and personality.
Fick, D.M. & Mion, L.C. (2008). Delirium Superimposed on Dementia. American Journal of Nursing, 108(1), 52-60.
Ajilore, O.A and Kumar, A. (2004). Delirium and Dementia. FOCUS, 2, 210-220.
Arnold, E. (2004). Sorting out the 3 D’s: Delirium, dementia, depression. Nursing, 34 (6), 36–42.