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.
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.
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.
What Can You do to Assist Older People Who Are Confused?
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.
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.
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
- https://info.eugeria.ca/en/dementia-and-delirium-what-are-key-differences/
- https://www.dementia.org.au/sites/default/files/helpsheets/Helpsheet-DementiaQandA21_Delirium_english.pdf
- https://www.verywellhealth.com/whats-the-difference-between-delirium-and-dementia-98838
- https://www.singlecare.com/blog/delirium-vs-dementia/
- https://www.saintlukeskc.org/health-library/difference-between-delirium-and-dementia
- https://www.agingcare.com/articles/delirium-vs-dementia-476403.htm
- https://www.aplaceformom.com/caregiver-resources/articles/delirium-vs-dementia
- https://www.seniorhelpers.com/fl/orlando/resources/blogs/learn-how-to-tell-the-difference-between-delirium-dementia/
- https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3255198/pdf/1840023.pdf
