Is It Delirium or Dementia? Both can be Scary – Know the Difference

Delirium and Dementia appear very similar on the surface. They are often confused. Even for medical professionals and caregivers, it can be easy to misinterpret the signals. It is possible for a person to have dementia and delirium, which further complicates the diagnosis.

Delirium can often be reversed.

Delirium causes confusion, disrupted behaviors, and disruptions in thinking; there can also be mood changes, perceptional changes, and changes in attention happens over days or weeks. There is disorganization in thinking patterns and the person may not be able to maintain focus. The person suffering from delirium may not be able to have a coherent conversation. They may be either “hyper-alert” or very lethargic. The symptoms can fluctuate throughout the day, and there may be times of the day that they are symptom-free. Some more obvious symptoms are alarming.

  • Hallucinations
  • Disorientation
  • Nonsense speech
  • Difficulty understanding speech

Many causes of delirium can be treated or prevented. Unfortunately, delirium is missed half of the time. Knowing the potential causes can be the first step towards finding the solution.

  • Illness-such as a urinary tract infection or influenza
  • Brain injuries-such as a stroke or unrecognized head injury
  • Withdrawal-from alcohol, nicotine, or stopping a medication
  • Medication-adverse reaction, mixing medications or taking with alcohol
  • Brain aging
  • Dementia
  • Electrolyte imbalance
  • Multiple medications
  • Dehydration
  • Malnutrition

With the changes in memory and intellect happen gradually. Notable changes appear over months and even years. For a diagnosis of dementia, there needs to be a decline in memory and at least one other cognitive area. The causes of dementia are related specifically to the brain.

  • Gradual dysfunction of the brain
  • Loss of brain cells

Many of the risk factors associated with dementia are genetic. Dementia can also be influenced by general health and lifestyle choices. The connections are still not fully understood.

  • Age – 30% risk if over 85 years, rare under 50 years
  • Female – may be due to hormonal changes as women age
  • Genetics – early or late chromosomal mutations
  • Brain Damage – from Alzheimer’s Disease, Parkinson’s Disease, AID’s, alcoholism and others
  • Damage to blood vessels – heart disease, diabetes, stroke, high blood pressure

A person with dementia can be prone to bouts of delirium. A person with unresolved delirium can develop dementia.

If you notice sudden behavioral or cognitive changes that occur over a few days or weeks, it may be a good idea to investigate the some of the multiple causes of delirium. Investigate any recent changes in medication or an undiagnosed infection.

Knowing the differences between the two conditions can keep delirium from becoming dementia or improve the symptoms of the individual who shows signs of both. If you need help, reach out to a local behavioral health provider, a Memory Care Community, or your physician.