Below is a table highlighting major differences between delirium and dementia in different 3P's aspects (Laske & Stephens, 2018).
|
Aspect |
Delirium |
Dementia |
|
Onset |
Acute/sudden and signs fluctuate with time | The slow and gradual process |
|
Cause |
Illnesses such as UTIs, conditions e..g. Dehydration and drug/substance withdrawal | Mostly facilitated by brain disorders such as Alzheimer's disease |
|
Target |
Attention | Memory |
|
Neurology |
Disrupts acetylcholine | Neuron degeneration |
|
Symptoms (general) |
They occur within a short lapse time of hours or days: sleepiness, behavior change to more quiet temperament frequented by confusion and various degrees of hallucination and hyperactivity | They take months or years to show:poor judgment and cognitive functions such as memory |
|
Consciousness |
Clouded levels | No/little effect |
|
Medical attention |
Urgent and Immediate | Necessary but not urgent |
|
Treatment |
Curable and reversible through associated infections or illnesses. | Medication is for slowing down the rate of progress |
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Mr. Gibson's Vulnerability
Delirium
According to Oldham (2019), delirium vulnerability factors include elderly age, drug and substance abuse history, pain, successive infections, dehydration and malnutrition and stress disorders including sleep deprivation.
Dementia
Vascular defects, chronic cognitive disorders e.g. Alzheimer's, toxins and infections such as lead and herpes respectively (Hubner, Kim & Boron, 2018).
Assessment Factors
Delirium
Mental status assessment and patient history (and family history sometimes) are the initial assessment tools used. Other methods include CAM, FAM-CAM, and 4AT. CAM incorporates thinking, consciousness and attention behaviors of the patient.
Dementia
Various sets of assessments are involved e.g. comprehensive, audiological and SLP which incorporates memory, perception, orientation and general communication (language). Other Alzheimer -related screenings and assessment tools include GPCOG and Mini-Cog (Pink, O’Brien, Robinson & Longson, 2018).
References
Laske , R. A., & Stephens, B. A. (2018). Confusion states: Sorting out delirium, dementia, and depression. Nursing made Incredibly Easy , 16 (6), 13-16.
Oldham, M. A. (2019). Delirium. In Perioperative Psychiatry (pp. 27-50). Springer, Cham.
Hubner, S., Kim, H., & Boron, J. B. (2018). Dementia Vulnerability: Minority Groups and Disease Progression. Innovation in Aging , 2 (Suppl 1), 914.
Pink, J., O’Brien, J., Robinson, L., & Longson, D. (2018). Dementia: assessment, management, and support: summary of updated NICE guidance. BMJ , 361 , k2438.
