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Is It Delirium or Dementia? They Are Not the Same

Memory issues are a large and often looming concern for aging residents of the Lehigh Valley. Our fear response when we lose our keys or can’t remember someone’s name often triggers the “Oh no, I have Alzheimer’s!” response. South Mountain Memory Care, providing memory care for Allentown and the Lehigh Valley, wants to keep you informed about memory issues. Here is information from the National Institutes of Health about the difference between temporary delirium and dementia.

Forgetful man scratching head

What is delirium?

Delirium is a mental state in which one is confused, disoriented, and unable to think or remember clearly. It usually starts suddenly and is often temporary and treatable.

There are three types of delirium:

  • hypoactive, when you are not active and seem sleepy, tired, or depressed
  • hyperactive, when you are restless or agitated
  • mixed, when you change back and forth between being hypoactive and hyperactive

What causes delirium?

Many different problems can cause delirium. Some of the more common causes include:

Who is more likely to get delirium?

Certain factors put you at risk for delirium, including:

  • being in a hospital or nursing home.
  • having dementia.
  • having a serious illness or more than one illness.
  • having an infection.
  • older age.
  • having surgery.
  • taking medicines that affect the mind or behavior.
  • taking high doses of pain medicines, such as opioids.

What are the symptoms of delirium?

The symptoms of delirium usually start suddenly, over a few hours or a few days. They often come and go. The most common symptoms include:

  • changes in alertness (usually more alert in the morning, less at night).
  • changing levels of consciousness.
  • confusion.
  • disorganized thinking, talking in a way that doesn’t make sense.
  • disrupted sleep patterns, sleepiness.
  • emotional changes: anger, agitation, depression, irritability, overexcitement.
  • hallucinations and delusions.
  • memory problems, especially with short-term memory.
  • Trouble concentrating.

How is delirium diagnosed?

Your healthcare provider may use many tools to make a diagnosis, such as:

  • your medical history, which includes asking about your symptoms.
  • physical and neurological exams.
  • mental status testing that checks for problems with your thinking and alertness.
  • lab and diagnostic imaging tests.

Delirium and dementia have similar symptoms, so it can be hard to tell them apart. You can also have both at the same time. The differences between them are that:

  • delirium starts suddenly and can cause hallucinations. It is mainly a problem with attention and staying alert. The symptoms may get better or worse and can last for hours or weeks.
  • dementia develops slowly and does not cause hallucinations. It usually starts with memory loss. The symptoms don’t change often, like they can with delirium. Dementia rarely gets better.

What are the treatments for delirium?

Treatment of delirium focuses on the causes and symptoms of delirium. The first step is to identify the cause. Often, treating the cause will lead to a full recovery. The recovery may take some time—weeks or even months. In the meantime, there may be treatments to manage the symptoms, such as:

  • controlling the environment, which includes making sure that the room is quiet and well-lit, having clocks or calendars in view, and having family members around.
  • medicines, including those that control aggression or agitation, and pain relievers if there is pain.
  • if needed, making sure the person has a hearing aid, glasses, or other devices for communication.

Can delirium be prevented?

Treating the conditions that can cause delirium may reduce the risk of getting it. Hospitals can help lower the risk of delirium by avoiding sedatives and ensuring that hospital rooms are kept quiet, calm, and well-lit. It can also help to have family members around and to have the same staff members treat the person each day (if possible).

The information on this site should not be used as a substitute for professional medical care or advice. Contact a healthcare provider if you have questions about your health.

MedlinePlus, https://medlineplus.gov/delirium.html, accessed November 14, 2024, non-copyrighted U.S. Government site

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