What Is the Difference Between Delirium and Dementia?

July 15, 2023 / Dementia

If your aging loved one begins to suddenly display signs of confusion or have emotional outbursts, it may be common to start thinking they have dementia, which is a permanent memory condition where memory and independent functioning progressively decrease over time. However, it is possible that a loved one could be dealing with delirium, which is a temporary abnormal state that causes confusion and emotional outbursts. Delirium is less common than dementia, and with similar symptoms, it can often be mistaken for dementia. Senior Care AZ, a senior placement agency in Arizona, is breaking down the differences between delirium and dementia: what they both are, their symptoms, how they may be different, and more. If you are aging or have loved ones who are aging, it is important to know the signs and symptoms of delirium and dementia so you can recognize these conditions and be aware of treatment options for your loved ones.

What Is the Main Difference Between Delirium and Dementia?

The main differences between delirium and dementia are their onset and progression. Individuals with delirium will often develop symptoms rapidly, within a few hours or days, and they will begin to act impaired and very different from their normal selves within this extremely short time frame. Dementia symptoms generally develop slowly over time. They will be more gradual, with an unclear starting point. Delirium will generally last for a short period where symptoms will stay the same, a few hours or days, and is referred to as an episode, while dementia, once onset, will last throughout the tenure of an individual’s life and begin to get worse over time.

What Is Delirium?

Delirium is a temporary mental state of impaired attention, focus, thinking ability, and alertness. Delirium is not a disease; it is a term to describe the mental state that is often the result of various conditions. Delirium results in a serious change in mental abilities and will result in a lack of awareness of someone’s surroundings. An individual experiencing delirium will generally act very differently than you are used to, and it will appear to come on very fast. Delirium is more common in older, hospitalized patients. Nearly 30% of hospitalized seniors will experience an episode of delirium at some point, and this risk is even greater in patients who’ve had surgery, increasing anywhere from a 10% to 50% higher chance of having an episode of delirium.

What Is Dementia?

Dementia is a condition where physical and memory impairing changes occur in the brain. Dementia is an umbrella term to describe a variety of conditions that cause these memory impairing changes to the brain, the most common of which is Alzheimer’s disease, which accounts for 60-80% of dementia cases. Dementia patients will often lose their ability to remember and think clearly, and they will often make poor or dangerous decisions.

Delirium vs. Dementia: Symptoms

Symptoms may be similar in patients dealing with delirium or dementia, but they can also have some unique symptoms that make it possible to distinguish between these two mental states.

Delirium Symptoms

Individuals experiencing an episode of delirium will often have symptoms such as confusion, altered levels of consciousness, and disrupted sleep patterns. They may have rapid emotional changes, especially a tendency towards anger, agitation, and depression. Individuals may deal with situations like hallucinations and delusions, and they may have trouble with concentration.

Dementia Symptoms

Dementia symptoms that overlap with delirium include confusion, agitation, and hallucinations. Other symptoms of dementia can include memory loss, poor judgment, confusion, and a shortened attention span. Individuals with dementia may have difficulty with communication, including a disrupted speech pattern. They may be prone to wandering or getting lost in places that were once familiar. Individuals may have difficulty completing the tasks of everyday living. They may become impulsive, apathetic, agitated, or have states of paranoia. Loss of balance and difficulty with movement are also common among individuals with dementia.

Delirium vs. Dementia: Causes

Delirium and dementia have very unique causes, which is another key difference between these two issues.

Delirium Causes

Delirium is often the result of different medical conditions. Medical conditions such as chronic illness and infections, hospitalizations, medication interactions and side effects, dehydration, organ failure, and cancer treatments have all been linked to causing delirium. Head injuries and alcohol or drug intoxication may also be the cause of a delirium episode.

Dementia Causes

Dementia is a disease that has no known cause. Risk factors for developing dementia include age, genetics, race, poor heart health, and traumatic brain injuries, but as for a single cause, there has not been one single pinpointed cause for the reason an individual will develop dementia.

Delirium vs. Dementia: Diagnosis

A diagnosis for delirium and dementia may start out the same, with a visit from a physician where they will evaluate the patient’s mental state, but the way in which they will work with a patient to diagnose them can be different.

Delirium Diagnosis

A delirium diagnosis will be made after reviewing medical history, observing the behavior of the patient, and taking a cognitive test. The cognitive test will use four evaluating factors to determine if the patient is in a state of delirium, including: the patient’s alertness,whether they are drowsy or agitated; the patient’s awareness, if they know their whereabouts, the time, and the date; the patient’s attention, if they can hold a conversation and pay attention to topics; if they have acute or fluctuating changes, whether the symptoms are sudden and if they come and go.

Dementia Diagnosis

A doctor will determine a dementia diagnosis by using more advanced cognitive assessments, such as the Mini Mental State Exam or the Mini-Cog test. These tests assess a patient’s cognitive abilities and will be used to determine if dementia is the cause of their symptoms.

Delirium vs. Dementia: Treatment

The treatment for dementia is very different from the treatment for delirium due to the differences in outcomes a patient can hope for.

Delirium Treatment

Delirium will be treated by determining the underlying cause of the delirium and focusing treatment on targeting this cause. This could include discontinuing a medical treatment that is causing the delirium or treating an infection. During treatment, healthcare professionals and family members should try to create a calming environment to soothe the patient’s delirium.

Dementia Treatment

Dementia treatment is not focused on a cure since there is no known cure, but instead on managing symptoms. Certain drugs can help manage mood and memory loss, but there are also non-drug alternatives that are known to provide some assistance with managing symptoms. These include increasing physical activity if possible, cognitive exercises, memory training, and ensuring adequate social stimulation for individuals.

Can Someone Who Has Dementia Also Experience Delirium?

The physical changes happening to an individual’s brain due to dementia put them at an increased risk of developing delirium. People with dementia can experience delirium episodes, which some people may mistakenly identify as a period of rapidly progressing dementia. Tracking your loved one’s symptoms can help ensure that, if they experience an episode of delirium, they are accurately diagnosed and properly treated.

How Can I Help Someone With Delirium?

It is important to keep track of your loved one’s symptoms and behavior so you can become aware of a possible episode of delirium as quickly as possible. Remaining an active part of their medical care can be a good option, especially if you are one of the individuals with the most frequent contact with your loved one. Stay connected by checking in with your elderly loved ones often. Use technology to stay in touch if you don’t live nearby. If you notice a loved one is not acting like their normal self, speak up. Speaking to their doctor may be something you are hesitant to do, but discussing the changes and symptoms you’ve noticed can change the outcome and insure they are treated for any condition they may have. If you notice a sudden and rapid difference in your loved one’s mental state or behavior, seek immediate care to ensure they are protected and can be treated in a safe environment. If your loved one has delirium, is being treated for delirium, or is recovering from it, it is important to work with them, their medical providers, and your family to come up with a reasonable long-term care plan. Ensuring they can complete the activities of daily living or have assistance with the activities, if needed, will help make sure they stay safe and healthy over time.