Is it delirium or dementia?

Hospital-acquired delirium is becoming a common and dangerous condition as our population ages. It can easily be confused with dementia, and is potentially avoidable, so it’s important to recognize the symptoms.
What is delirium?Delirium is a sudden and severe confused state that comes and goes over the day. It can affect people’s attention, memory and understanding of the environment.

People with delirium may have trouble paying attention to what is going on around them and to the things they normally do. Delirium may also cause dramatic changes in personality and behavior.

10% - 60% of older patients in hospitals may develop delirium during their stay. If untreated, it can lead to longer stays in the hospital, transfers to a long-term care facility and even death.

Delirium is a warning sign that something is happening in the body and needs urgent medical attention.

What is dementia? Dementia is a more permanent and irreversible disease that develops gradually and slowly, with symptoms worsening over time.

People with dementia have difficulty remembering recent events but their ability to focus is usually not affected and a loss of consciousness only occurs in the later stages of the condition. Dementia is due to a chronic disorder such as Alzheimer’s disease.

Who's at risk? People may develop delirium if they have:

• Underlying dementia such as Alzheimer’s disease or stroke-related dementia
• Previous history of delirium
• Medical frailty (multiple medical problems along with physical disabilities)
• Major depression
• An acute medical illness, (such as pneumonia or lung infection, bladder infection, soft tissue infection), heart disease, internal bleeding
• Had major surgery, particularly hip surgery, brain surgery, or vascular surgery
• Been admitted to the Critical Care Unit (Intensive Care Unit/ICU)

What are the symptoms of delirium?

• Sudden change of consciousness and they may not be as alert as usual.
• Change in brain function. They become inattentive, forgetful, disoriented have slurred speech etc.

If you notice any of the signs or symptoms above in a loved one, please inform their health care team.
What's being done to improve the diagnosis of delirium? In some parts of Canada, hospitals have made changes to improve the detection of delirium.

Vancouver General Hospital's Acute Care for Elders Units, or ACE units, have a multidisciplinary team of specialists, elderly-friendly surroundings and policies designed to promote independence and cognitive (brain function) stimulation. The ACE Units at Vancouver General Hospital recognized as national and international leaders in providing the best hospital care for older patients.