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Distinguishing Delirium from Dementia
Distinguishing Delirium from Dementia
Decline in cognitive function in older people is most commonly caused by delirium, depression or dementia and although these conditions are distinctly different, it can be difficult to distinguish between them in the initial stages of assessment. Evaluation is usually based on history, observation, and physical examination and it is important to know about the person's baseline level of functioning in order to determine the extent and rate of change. Determining whether a patient has delrium and the cause of the delirioum is often a matter of urgency as the underlying problem may be life-threatening (e.g., drug toxicity or electrolyte imbalance).
The onset of delirium tends to be relatively sudden, but may be superimposed upon existing dementia. Severity often fluctuates over the course of the day and there is often disturbance in the sleep-wake cycle and psychomotor behaviour. Dementia is caused by several different brain disorders, including Alzheimer's Disease, and is characterised by multiple cognitive deficits that include memory impairment. The onset of dementia is usually quite gradual.
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