Symptoms of Delirium and differentiate it from Dementia

Delirium is a severe neuropsychiatric disorder of deficit in attention, awareness and cognition, most often effecting elderly people (mostly 65 years and older) . The disorder can develop over few hours to some days, often over a short time. The patient experience a unclear consciousness of the environment, with a reducement in their abilities to change focus or sustain their attention. Moreover as there is a deficit in the cognitive processes as well, this can include problem with language, memory, planning and the feeling of disorientation. Patient can for example mistaken the day, people, places and time. In addition as their attention is reduced they often have decreased sensory acuity, and should be spoken to with a slower and loader voice (Gleason, 2003).

            The reasons for developing delirium is many, including trauma, drug use, stroke or most frequent, an acute medical illness. Patient most often experience a altered arousal, as they can go from a lack of response (at a close to coma level) to hypervigilance and severe agitation (Wilson, 2020). In addition they feel distress and can sometime experience hallucinations and delusions as well as a change in their mood. The frequency of delirium varies from some few days to weeks and even mounts. 

Patients experiencing delirium is common in patients that are in the hospital. Delirium can be divided into three different types, as a result of their symptoms, including hypoactive, hyperactive and a mixed between them both. On one hand a patient with hypoactive delirium be seen as being restless and agitated, not wanting to get medical help. On the other hand hypoactive delirium is seen as very tired and drowsy and have a lot of problems staying focused. It is harder to notice as the patient often spend a lot of time in bed and are quiet (Wilson, 2020).

Many people have problems differentiate between delirium and dementia, as many of the mentioned symptoms are similar. However it is important to see the time the disorders have developed, dementia over time while delirium can develop suddenly and symptoms can fluctuate throughout a day. Moreover a significant different is the inattention patient with delirium experience, with not able to focus on a task. Nevertheless it is important to know that patient with dementia can experience delirium, as it is the most common risk factor for developing delirium (Cole et al., 2002). 

                                       References: 

Cole, McCusker, & Han. (2002).  Symptoms of Delirium Among Elderly Medical Inpatients With or Without Dementia. Neuropsychiatry: https://neuro.psychiatryonline.org/doi/full/10.1176/jnp.14.2.167

Gleason, O. C. (2003). Delirium. American Familiy Physician: https://www.aafp.org/afp/2003/0301/p1027.html

Wilson. (2020). Delirium. Nature Reviews Disease Primers: https://www.nature.com/articles/s41572-020-00223-4