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Dementia And Delirium
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Reviewed by the Faculty of Harvard Medical School

Dementia And Delirium

Delirium is a state of acute confusion that can resemble dementia. According to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition:

A diagnosis of delirium is made if:

  • There is disturbance of consciousness (i.e., reduced clarity of awareness of the environment) with reduced ability to focus, sustain, or shift attention.


  • There is a change in cognition such as memory deficit, disorientation, and language disturbance.


  • The disturbance develops over a short period of time (usually hours and days) and tends to fluctuate during the course of the day.


  • There is evidence from the history, physical examination, or laboratory findings that the disturbance is caused by a medical condition.

The causes of delirium are numerous. In older persons, it is commonly caused by medication intoxication, infections (particularly of the chest and bladder), metabolic disturbances (for example, kidney failure and thyroid disease) and cardiovascular and brain disorders.

If delirium is suspected, you must consult a health-care provider immediately. It may be necessary to admit you to hospital to obtain a full history and examination. Blood tests, urine analysis, X-rays and a brain scan may also be performed to determine the cause, which will dictate treatment. For example, antibiotics may be given if an infection is confirmed or medications may be discontinued if medication intoxication is confirmed. Failure to seek medical help may result in death.



Last updated April 24, 2009


   
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