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Difference Between Delirium and Dementia

March 2, 2018Posted byRanidu

Key Difference – Delirium vs Dementia

Dementia and delirium are often seen among elderly people, and these diseases are responsible for the deterioration of cognitive functions in the affected group of patients. Delirium, also known as acute organicpsychosisor toxic confusional state,is an acute or subacute brain failure in which the impairment of attention is accompanied by abnormalities in mood and perception. Dementia, on the other hand, is a clinical syndrome which is defined by the presence of acquired loss of higher mental functions, sufficient severity to cause social or occupational impairment and the occurrence in clear consciousness. The main difference between delirium and dementia is thatin dementia, there are no alterations in the level of consciousness while in delirium, the consciousness is impaired.

CONTENTS

1.Overview and Key Difference
2.What is Delirium
3.What is Dementia
4.Similarities Between Delirium and Dementia
5.Side by Side Comparison – Delirium vs Dementia in Tabular Form
6.Summary

What is Delirium?

Delirium, which is also known asacute organic psychosisortoxic confusional state,is an acute or subacute brain failure in which the impairment of attention is accompanied by abnormalities in mood and perception.

Predisposing Factors for Delirium

  • Extremes of age
  • Brain damage
  • Dislocation to an unfamiliar environment
  • Sleep deprivation
  • Sensory extremes
  • Immobilization
  • Visual and hearing impairment

Causes of Delirium

  • Systemic infections
  • Metabolic disturbances in conditions such asheart failure,renal failure, and liver failure
  • Vitamin B12 and thiamine deficiency
  • HypothyroidismandCushing’s syndrome
  • Epilepsyand space-occupying lesions in the cranial cavity
  • Adverse effects of drugs such as anticonvulsants and antimuscarinic agents
  • Drug and alcohol withdrawal

Diagnostic Criteria

  • Disturbance of consciousness
  • Change in cognition
  • Development of the symptoms over a short period of time (hours to days)
  • Fluctuation over the course of day

Key Difference - Delirium vs Dementia

Management

A proper history can reveal the underlying cause. The patient should be treated in a place that does not allow exits. The nutritional status of the patient must be improved. Any current medications that the patient is on should be thoroughly reviewed. Haloperidol has been proven to be effective in the management of severe delirium. The use of benzodiazepine is not advocated because it can prolong the period of confusion.

What is Dementia?

Dementia is a clinical syndrome which is defined by the following criteria:

  • Acquired loss of higher mental functions
  • Sufficient severity to cause social or occupational impairment
  • Occurring in clear consciousness

Dementia is most often an irreversible, progressive condition.

Causes of Dementia

  • Degenerative brain conditions such as Alzheimer’s disease
  • Vascular Lesions
  • Metabolic causes such as uremia
  • Toxicity of heavy metals and alcohol
  • Vitamin B12 and thiamine deficiency
  • Trauma
  • Infections such as HIV
  • Hypothyroidism and hypoparathyroidism
  • Psychiatric illnesses

Difference Between Delirium and Dementia

Clinical Assessment

A clear and descriptive history should be carefully taken right at the beginning. The patient may not divulge all the relevant information mostly due to the social stigma associated with conditions like this. The mini-mental state examination and Addenbrooke’s Cognitive examination are the tools that can be used to assess the mental health status of the patient.

Investigations

  1. Blood Tests
  • FBC, ESR, vitamin B12
  • Urea and electrolytes
  • Glucose
  • Liver biochemistry
  • Serum calcium
  • Thyroid functions
  • HIV serology
  1. 成像
  • CT or MRI brain scan
  1. Occasionally brain biopsies and genetic studies

Management

在大多数情况下,痴呆的确切原因identified. Therefore, only supportive management that is aimed at preserving the dignity of the patient is provided. Pharmacological agents such as cognitive enhancers, cholinesterase inhibitors, and memantine are often prescribed, but their effect in modifying the disease progression remains controversial. Since there is a strong association between dementia and depression, antidepressants should be given when depression is suspected.

What are the Similarities Between Delirium and Dementia?

  • Both conditions are associated with an impairment in the cognitive functions.
  • Elderly people are more likely to be affected by dementia and delirium.

What is the Difference Between Delirium and Dementia?

Delirium vs Dementia

Delirium, also known as acute organic psychosis or toxic confusional state, is an acute or subacute brain failure in which the impairment of attention is accompanied by abnormalities in mood and perception Dementia is a clinical syndrome which is defined by the following criteria,

  • Acquired loss of higher mental functions
  • Sufficient severity to cause social or occupational impairment
  • Occurring in clear consciousness
Consciousness
Delirium occurs with impaired consciousness. In dementia, the patient has a clear consciousness.
Symptoms
Symptoms appear over a short period of time in delirium. There is a progressive onset of symptoms; it may take years for them to become evident.
Diagnostic Criteria
  • Disturbance of consciousness
  • Change in cognition
  • Development of the symptoms over a short period of time (hours to days)
  • Fluctuation over the course of day
  • Acquired loss of higher mental functions
  • Sufficient severity to cause social or occupational impairment
  • Occurring in clear consciousness
Causes
  • Systemic infections
  • Metabolic disturbances in conditions such as heart failure, renal failure, and liver failure
  • Vitamin B12 and thiamine deficiency
  • Hypothyroidism and Cushing’s syndrome
  • Epilepsy and space-occupying lesions in the cranial cavity
  • Adverse effects of drugs such as anticonvulsants and antimuscarinic agents
  • Drug and alcohol withdrawal
  • Degenerative brain conditions such as Alzheimer’s disease
  • Vascular Lesions
  • Metabolic causes such as uremia
  • Toxicity of heavy metals and alcohol
  • Vitamin B12 and thiamine deficiency
  • Trauma
  • Infections such as HIV
  • Hypothyroidism and hypoparathyroidism
  • Psychiatric illnesses
Diagnosis
A proper history can reveal the underlying cause most of the time. The patient should be treated in a place that does not allow exists. The nutritional status of the patient must be improved. Any current medications that the patient is on should be thoroughly reviewed. Haloperidol has been proven to be effective in the management of severe delirium. The use of benzodiazepine is not advocated because it can prolong the period of confusion. 在大多数情况下,痴呆的确切原因identified. Therefore, only supportive management which is aimed at preserving the dignity of the patient is provided. Pharmacological agents such as cognitive enhancers, cholinesterase inhibitors, and memantine are often prescribed, but their effect in modifying the disease progression remains controversial. Since there is a strong association between dementia and depression, antidepressants should be given when depression is suspected.

Summary – Delirium vs Dementia

Delirium, which is also known as acute organic psychosis or toxic confusional state, is an acute or subacute brain failure in which the impairment of attention is accompanied by abnormalities in mood and perception. A diagnosis of dementia is made by observing acquired loss of higher mental functions, sufficient severity to cause social or occupational impairment, and occurring in clear consciousness. Unlike in dementia where there is no change in the patient’s level of consciousness, in delirium, the consciousness is impaired. This is the major difference between delirium and dementia.

Reference:

1.Kumar, Parveen J., and Michael L. Clark. Kumar & Clark clinical medicine. Edinburgh: W.B. Saunders, 2009.

Image Courtesy:

1. “Delirium” by Erich Ferdinand(CC BY 2.0)通过Flickr
2. “63612” (Public Domain) viaPixabay

Related posts:

Difference Between Delirium and Dementia Difference Between Amnesia and Dementia Difference Between Alzheimer’s and Dementia Difference Between Alzheimers and DementiaDifference Between Alzheimers and Dementia Difference Between Dementia and Psychosis

Filed Under:DiseasesTagged With:acute organic psychosis,Compare Delirium and Dementia,Delirium,Delirium and Dementia Differences,Delirium and Dementia Similarities,Delirium Causes,Delirium Definition,精神错乱诊断,Delirium Management,Delirium vs Dementia,dementia,dementia causes,Dementia Definition,Dementia Diagnosis,Dementia Management,Predisposing Factors for Delirium,toxic confusional state

About the Author:Ranidu

Ranidu is passionate about writing articles on medical topics in general parlance. His experience in communicating with the general public during his medical practice has enabled him to describe facts that a layman has to know about a particular disorder in a concise and understandable manner.

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