You may think that delirium and dementia are the same disorder, but that is not the case. In fact, a comparison of delirium vs dementia can show you just how different the disorders are. There are 7.7 million new cases of dementia every year. The World Health Organization says doctors diagnose a new case every four seconds. About 47.5 million people live with dementia worldwide, and by 2030, there will be about 75.6 million cases. It's one of the main reasons for dependency and mental impairment in the geriatric group.

In the U.S., at least five million people live with age-related dementia. Consequently, as the populace ages, this number will rise. One of every six women and one of even ten men living past 55 will develop dementia.

WHAT IS DELIRIUM?

Delirium is a mental disturbance, meaning it impacts mental abilities. As a result, delirious people have confused thinking and reduced awareness of the environment. The onset of delirium is usually very rapid and takes place within hours or a few days. Something often triggers it.

There are many contributing factors to delirium. For example, it could result from a chronic illness, metabolic imbalance, medication, surgery, and alcohol. Similarly, infection or drug withdrawal may also cause sudden delirium. It is a medical emergency, and you should immediately seek help if someone you love exhibits symptoms.

WHAT IS DEMENTIA?

Dementia demonstrates a constellation of signs which show the loss of brain function. As a result, the person's ability to remember diminishes and they find it hard to communicate and think. It's a gradual onset, where first a person may simply forget. Later, they may find it hard to follow instructions or do daily tasks, even brushing teeth or dressing up may be hard. As time passes, they may fail to understand what's spoken to them and forget people. They also have changes in mood and become restless.

The process is gradual and often takes place over months and years. Caregivers may miss the onset of dementia because it's so insidious. In fact, an outsider may be the first to notice the change. There are seven stages of dementia.

DELIRIUM VS DEMENTIA

Dementia vs. delirium is a hard comparison because they both alter the mental state. Certainly, they have similar signs and symptoms. But their causes are different. Their outcomes and treatment also differ. The first obvious difference is the onset. Dementia happens slowly over months. Delirium is a medical emergency. It happens suddenly without warning over hours.

People with dementia are forgetful and confused. They may have trouble talking and understanding you. Delirious people may be restless, quiet, sleepy and distressed. People with dementia often have other co-morbid illnesses like Alzheimer's and Parkinson's.

DISEASES

SYMPTOMS

TYPES

TREATMENT

DELIRIUM

  •  They find it hard to stay focused on a topic of conversation
  • Often they switch topics while talking
  • Poor thinking skills
  • Hard to recall recent events
  • Their behavior changes too. They may hallucinate, become combative, scream, and have altered sleep habits. 
  • Emotionally, they might exhibit paranoia, unusual fear, depression, and anger.
  • Sometimes the sleep-wake cycle of day and night is completely reversed
  • When questioned, they have no clue its happening or why.
  • Hyperactive Delirium
  • Hypoactive Delirium
  • Mixed Delirium

The first step in treatment is to remove the trigger of the delirium. So stop a particular drug, fix any metabolic imbalances and treat the infection. Delirium can be treated almost immediately.

DEMENTIA

  • Loss of memory
  • Mental Decline
  • They may find it difficult to speak or understand language
  • They may find it difficult to speak or understand language, make things up
  • Can't recognize common objects
  • irritable and reckless
  • Often, they experience anxiety, feel lonely, and have mood swings
  • Muscle movements may become difficult, and their gait gets unsteady. As a result, they fall frequently and have a jumbled speech.

Unlike delirium, there are no types of dementia.

Dementia, on the other hand, requires long-term and supportive care. There's no treatment for dementia as of now. Although drugs do slow its progression do exist.

Symptoms Of Delirium

Delirium vs dementia symptoms may seem similar, but they are quite different. People with delirium have a reduced awareness of the environment. So they find it hard to stay focused on a topic of conversation. Often they switch topics while talking. They get stuck on an idea and cannot move on. Or they are easily distracted. Usually, they withdraw from society and friends. And they also have poor thinking skills.

They find it hard to recall recent events. Their disorientation is obvious, and they ramble on without making sense. Their behavior changes too. They may hallucinate, become combative, scream, and have altered sleep habits. Sometimes the sleep-wake cycle of day and night is completely reversed.

Emotionally, they might exhibit paranoia, unusual fear, depression, and anger. They may be inappropriately happy and show other personality changes. When questioned, they have no clue its happening or why. Delirium vs dementia symptoms may seem similar, but they are quite different.

Symptoms Of Dementia

The symptoms of dementia include loss of memory, mental decline, confusion that worsens in the evening and lack orientation. They may find it difficult to speak or understand language, make things up, and can't recognize common objects. Behaviorally, they are irritable and reckless.

They exhibit personality changes and a lack of restraint. Since they can't remember, they wander and get lost. Often, they experience anxiety, feel lonely, and have mood swings. Psychologically, though, they may fall into depression, hallucinate, or become paranoid. Muscle movements may become difficult, and their gait gets unsteady. As a result, they fall frequently and have a jumbled speech. That makes delirium vs dementia a bit different.

Types Of Delirium

Three types of delirium exist. These are hyperactive, hypoactive, and mixed delirium. Hyperactive delirium is the easiest to recognize. It includes restlessness, an agitated state, mood changes, hallucinations, and refusal to cooperate. Hypoactive delirium includes inactivity. The person may be sluggish, drowsy, or in a daze. Mixed delirium includes both hyperactive and hypoactive signs and symptoms. The person may cycle back and forth between the two states.

Types Of Dementia

Unlike delirium, there are no types of dementia. But there are many diseases that cause dementia. Some of them are Alzheimer's disease, Frontotemporal disorders, and Lew Body Dementia. Then there's dementia from vascular causes, Korsakoff syndrome, Parkinson's and hydrocephalus.

STAGES OF DEMENTIA

Another way delirium vs dementia differs is in the stages, or types, of the diseases. There are seven stages of dementia. Stage one is where there's no cognitive decline. In stage two, people exhibit very mild cognitive decline with forgetfulness as the main sign. Next, stage three represents mild cognitive decline which appears seven years before dementia sets in. The next stages are much worse.

Stage four is a moderate cognitive decline where people withdraw from family. Stage five of the disease is when a moderately severe cognitive decline takes place. Here daily activities like dressing and bathing become difficult. Likewise, stage six is where severe cognitive decline takes place and is called Middle Dementia. At this stage, people may stop talking and become incontinent. Finally, Stage seven is very severe cognitive decline. These people require the most assistance with almost everything.

SEVEN STAGES OF DEMENTIA

  • 1
    There's no cognitive decline
  • 2
    People exhibit very mild cognitive decline with forgetfulness as the main sign
  • 3
    Mild cognitive decline which appears seven years before dementia sets in
  • 4
    A moderate cognitive decline where people withdraw from family
  • 5
    The disease is when a moderately severe cognitive decline takes place
  • 6
    Where severe cognitive decline takes place and is called Middle Dementia
  • 7
    Very severe cognitive decline

DIAGNOSING DELIRIUM VS DEMENTIA

Dementia vs. delirium is difficult to distinguish if a person has both. In fact, delirium occurs often in people with dementia. Episodes of delirium do not mean that a person has dementia. Hence, to diagnose dementia, an assessment is done. This is to confirm the progressive decline of memory and brain function. The most common cause of dementia is Alzheimer's disease.

Delirium might present itself suddenly and needs immediate medical care. No matter how subtle, if someone exhibits changes in behavior or speech seek medical help. You want to ensure they're not having a stroke or other neurological impairment. Relatives and friends should watch for signs or symptoms of delirium. At the first sign of a change in behavior, meet with a doctor. If you notice signs of delirium, report it. Don't assume it's temporary or will resolve on its own. Delirium could be a sign of an underlying pathology.

RISK FACTORS

Doctor treating an old man

There are certain groups of people at an increased risk of delirium vs dementia. Primary among them are those on long hospital stays. This could be after surgery or intensive care stays. People who've had strokes or Parkinson's are more susceptible to it. Those who have a hearing or visual impairment tend to become delirious faster. Multiple medical problems are additional risk factors for delirium. Research now shows high blood pressure, obesity, high cholesterol levels and smoking are risk factors. Alcohol, head injuries, depression and lesser formal education, are also liable.

Therefore, alcoholism, head injuries, depression, hypertension, obesity, and smoking are risk factors for dementia. In contrast, longer hospital stays, surgeries and sensory impairment are risk factors for delirium.

COMPLICATIONS

old man standing with walker

Delirium may last only a few hours or as long as a few days. Once the contributing factors to delirium are treated, the recovery time is short. The degree of recovery depends on the general health and mental status of the person. People with dementia may experience a decline in thinking skills. They may not make a full recovery.

Those with other chronic illnesses may worsen if not regain complete brain function. Delirium can also worsen general health and affect recovery after surgery. It can also increase the need for institutional care.

PREVENTION

The best approach to delirium vs dementia is prevention. You can prevent delirium by avoiding triggers. Try and avoid long hospital stays, invasive procedures, noise, lack of natural light, and poor sleep.

Dementia can be prevented by promoting better sleep hygiene in the elderly. Furthermore, remind people where they are. Orient them of their surroundings. Take medications on time and make a chart of cognitive and basic functions. Because this will help you identify early signs of dementia if they occur. Encourage human interaction and physical contact can also delay dementia. Constant cognitive stimulation through, crosswords, puzzles, board games and reading can prevent dementia.

TREATMENT

The first step in treatment is to remove the trigger of the delirium. So stop a particular drug, fix any metabolic imbalances and treat the infection. Delirium can be treated almost immediately.

Dementia, on the other hand, requires long-term and supportive care. There's no treatment for dementia as of now. Although drugs do slow its progression do exist.

SUPPORTIVE CARE

Supportive care includes protecting the respiratory airway, providing fluids and adequate nutrition. It involves assisting the person to get around, treat pain if any. This care also addresses any existing incontinence and avoiding restraints. It must involve providing a safe environment where a person can be fully functional. Therefore, the more involved family members are, the better.

Have the person's room lit dimly. Remove all sources of noise and stimulation at night. The need for sleep medication will be less in the presence of a family member. Be careful with medications. It's not impossible to cope with dementia.

Since delirium is temporary and usually resolved within hospitals, there's no additional support required for delirium. Certainly, after the main cause of delirium is treated, most patients can go home.

MEDICATIONS

medicine on hand

If you have a family member experiencing delirium, talk to the doctor about medications. Certain drugs trigger delirium. Like drugs for pain, epilepsy, and asthma. Similarly, psychiatric drugs for sleep, allergy medications, and anti-Parkinson's drugs trigger delirium. Seek alternatives and use behavior therapy to help the person stay calm. Offer an environment that is non-threatening and less agitating for them. They seek comfort in the familiar so don't change their environments too frequently.

Medications for dementia are limited. Parkinson's disease and Alzheimer's have medications to slow their progression. But dementia is progressive and diseases like Huntington's have no cure. Most drugs are supportive and not curative in the case of dementia.

WHAT SHOULD YOU DO?

Doctors have become better at recognizing delirium vs dementia. They also address issues quicker to resolve them faster. The trouble is, do care partners and caregivers recognize this too? Studying daily habits and routines of a family member will help you notice subtle behavior changes.

In people over 65, you have to stay alert for delirium, Delirium can be life-threatening. If there's a change in speech, behavior, thought process and function from the usual, report it. Educate yourself. Connect with other caregivers, so that you don't feel like you're battling it alone. Caregivers should always consider non-pharmacological ways first when addressing any early dementia symptoms. This is important to reduce the dependence on medication. Geriatric patients take a variety of medications as it is.

STAY INFORMED

Caregivers need to stay informed about dealing with delirium vs dementia. Learn as much as possible as soon as you can. From monitoring their food to which doctors to meet. You need to equip yourself to handle this better without experiencing burnout yourself. Once you know what to expect, it won't be as daunting. You can't do it all alone. Seek help. Long-term caregiver resources are available. Remember that there is no such thing as a perfect caregiver. You cannot do it all. When people offer you their help, always say yes. Encourage your loved one to do as much as possible on their own. Schedule exercise and outdoor activity into their routine and yours. Have them participate in their favorite activities to keep them sharp. Plan for the future.

YOU ARE NOT ALONE

old people holding hands

There's no need to feel hopeless and alone in your fight against delirium vs dementia, because you aren't. There are plenty of resources available. In dealing with dementia, as a caregiver devise strategies. You may question the diagnosis in moments of lucidity, that's perfectly normal. However, documenting the day to day progress of a loved one can help. Remember, a diagnosis of dementia doesn't mean that life is over.

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