Delirium or Dementia: Know the Difference


ORLANDO, Fla. (Ivanhoe Newswire) — More than five million people in the U.S. are living with dementia. It affects attention, memory, and judgement. However, in the hospital dementia is commonly misdiagnosed as delirium. A mistake that can delay treatment to slow the progression of the disease. There are ways you can distinguish between dementia and delirium and get the help your loved one needs.

More than seven million hospitalized patients in the U.S. will experience some form of delirium every year. Forty-five percent of those patients will have persistent delirium at discharge and 26 percent will experience delirium three months after being in the hospital. When delirium lasts that long, could it be something else?

Barbar Kahn, MD, Critical Care Physician, Regenstrief Institute at Indiana University says, “It is sometimes very difficult to differentiate between delirium and dementia because sometimes they are superimposed on each other.”

Since cognition impairment is present in both conditions, how can you spot the difference?

“The main difference between delirium and dementia is delirium develops acutely and it tends to fluctuate. So the patient could be fine at one moment and very soon they can be fluctuating,” continued Dr. Kahn.

Dementia is a chronic condition. Delirium is short lived and mainly affects attention, while dementia mainly affects memory. And the most important distinction between the two conditions is that delirium is reversible, while dementia is not.

“If by a few months after discharge if they feel that the things are not getting better and those symptoms are persistent, then it might be time to go over to a specialized memory clinic,” Dr. Kahn explained.

To get a proper diagnosis and the help your loved one needs.

Doctor Kahn also reports that COVID-19 has sent delirium rates skyrocketing. Up to 75 percent of COVID-19 patients have been affected by delirium.

Contributors to this news report include: Milvionne Chery, Producer; and Roque Correa, Editor.

REPORT #2815

BACKGROUND: Dementia is a progressive decline in memory and at least one other cognitive area like attention, orientation, judgment, abstract thinking, and personality. Dementia is rare in under 50 years of age and the incidence increases with age. In order to make a diagnosis of dementia, delirium must be ruled out.  However, patients with dementia are at increased risk of delirium and may have both. Delirium is an acute disorder of attention and global cognition (memory and perception) and is treatable. The diagnosis is missed in more than 50% of cases. The risk factors for delirium include age, pre-existing brain disease, and medications. There are many causes like dementia; electrolyte disorders; infection; prescription drugs; injury, pain, or stress; and unfamiliar environment. Prevention of delirium includes the avoidance of psychoactive drugs, quiet environment, daytime activity, dark and quiet at night, visual and hearing assistive devices, orientation devices, and avoidance of restraints.


COVID AND DELIRIUM: With COVID cases again increasing, a symptom of the virus, delirium, is gaining new notice. One study reports between 20 to 30% of hospitalized COVID patients develop delirium while another study indicates as many as 70% of critically ill patients are affected. There are two types of delirium. Hyperactive delirium is the overactive form in which a patient can be aggressive and restless, sometimes suffering delusions or hallucinations. Hypoactive delirium is the underactive form in which patients may appear sleepy, slow to respond, withdrawn, and not communicating with others. According to neurocritical care specialist Pravin George, DO, Cleveland Clinic, one cause of delirium in COVID patients could be a lack of oxygen because of how the virus attacks the lungs. Another cause could be the body’s reaction to the virus. “Inflammation caused by the way the body’s immune system overreacts to the virus could block blood to a patient’s brain,” says Dr. George.


A POSSIBLE NEW DRUG: The FDA will decide early this year, based on its own analysis of clinical trial data and an advisory panel’s review of the evidence, whether aducanumab will be approved for use in Alzheimer’s patients. Aducanumab is a monoclonal antibody engineered in a lab to stick to the amyloid molecule that forms plaques in the brains of people with Alzheimer’s. Most researchers believe the plaques form first and damage brain cells, causing tau tangles to form inside them, ultimately killing the cells. Once aducanumab has stuck to the plaque, your body’s immune system will come in and remove the plaque. The hope and expectation is once the plaques are removed, the brain cells will stop dying, and thinking, memory, function, and behavior will stop deteriorating. If this works, aducanumab would be the first drug that actually slows down the progression of Alzheimer’s. That means we could turn Alzheimer’s from a fatal disease into one that people could live with for many years. And for researchers, it means that more than 20 years of scientific work, suggesting that removing amyloid from the brain can cure Alzheimer’s, may be correct.


* For More Information, Contact:

Regenstrief Institute, PR

Free weekly e-mail on Medical Breakthroughs from Ivanhoe. To sign up: