Differences Between Delirium and Dementia*
Differences Between Delirium and Dementia*
Feature | Delirium | Dementia |
|---|---|---|
Onset | Sudden, with a definite beginning point | Slow and gradual, with an uncertain beginning point |
Duration | Days to weeks, although it may be longer | Usually permanent |
Cause | Almost always another condition (eg, infection, dehydration, use or withdrawal of certain medications) | Usually a chronic brain disorder (eg, Alzheimer disease Alzheimer Disease Alzheimer disease causes progressive cognitive deterioration and is characterized by beta-amyloid deposits and neurofibrillary tangles in the cerebral cortex and subcortical gray matter. Diagnosis... read more , dementia with Lewy bodies Dementia with Lewy Bodies and Parkinson Disease Dementia Lewy body dementia includes clinically diagnosed dementia with Lewy bodies and Parkinson disease dementia. Dementia with Lewy bodies is chronic cognitive deterioration characterized by cellular... read more , vascular dementia Vascular Cognitive Impairment and Dementia Vascular cognitive impairment and dementia is acute or chronic cognitive deterioration due to diffuse or focal cerebral infarction that is most often related to cerebrovascular disease. (See... read more ) |
Course | Usually reversible | Slowly progressive |
Effect at night | Almost always worse | Often worse |
Attention | Greatly impaired | Unimpaired until dementia has become severe |
Level of consciousness | Variably impaired | Unimpaired until dementia has become severe |
Orientation to time and place | Varies | Impaired |
Use of language | Slow, often incoherent, and inappropriate | Sometimes difficulty finding the right word |
Memory | Varies | Lost, especially for recent events |
Need for medical attention | Immediate | Required but less urgently |
Effect of treatment | Usually reverses symptoms | May slow progression but cannot reverse or cure the disorder |
* Differences are generally true and helpful diagnostically, but exceptions are not rare. For example, traumatic brain injury occurs suddenly but may result in severe, permanent dementia; hypothyroidism may produce the slowly progressive picture of dementia but be completely reversible with treatment. | ||