Features Distinguishing Delirium and Dementia

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Cognitive Disorders in the Elderly
Features Distinguishing Delirium and Dementia
Delirium
Dementia
Key features
Acute onset
Fluctuating course
Disorganized thinking
Altered level of consciousness
Inattention, distractibility
Underlying medical cause
Cognitive deficits in multiple domains, including memory
Progressive deterioration (months/years)
Cognitive impairment interferes with activities of daily living
No disorder of alertness
Presentation
An acute disorder usually associated with medical illness, medications, etc.
More slowly progressive cognitive impairment
Includes most dementias, benign senescent forgetfulness
Impaired cognition associated with affective disorders or psychoses
Patients rarely seek medical care for symptoms
Lack of insight common
Usually brought in by family, friends
Delay in diagnosis common
Caregivers may gradually take on more care for the patient, "masking" the true magnitude of the deficits
Onset
Acute
Insidious
Duration
Days/weeks
Months/years
Attention
Distracted
Usually normal
Level of consciousness
Increased/unchanged/ decreased
Cognition
Disorganized
Impoverished