Question

Differentiate delirium from dementia and give an example of each. How would a depression diagnosis cloud the differential?

Answer 1

Differentiation of delerium and dementia

delerium

dementia

rapid onset and symptoms fluctuate during day time. It can affect any age group manifested by reduced awareness of environment, disorders of perception, thought, speech, and attention deficits. usually of brief duration . Client focus on one task or idea. may occur postoperatively or following head injury, alcohol or drug intoxication, acute disease and injury.

Gradual onset loss of intellectual abilities resulting to impaired social and occupational functioning( Cognitive impairement), may be temporary or gradual loss occur predominently seen in elderly Personality chnages- exageration of former charecteristics- suspecious, lack of trust to others. lack of hygiene- formerly they might be neat and tidy, but presently they become less order, sloppy and unhygenic. Memory impairement - recent and remote memory loss but long term memory intact causes -old age, infectious diaseses, circulatory disorders, trauma, Alzheimer's disease, Pick's disease, Chonic diseseases like Diabetes mallitus,Naurosyphillis, Korsakoff's syndrome.

How would a depression diagnosis cloud the differential?

depression	delerium and dementia
depression is a mood disorder, charectrised ny loss of ambition, lack of interest in activiites. onset is faster than dementia but varies, symptoms are worse in the morning. Memory loss not predominant. ( selective). impaired judgement is present due to lack of interst and concentration	delerium has rapid onset days or hour. onset of dementia is gradual, takes weeks or months. memory loss is predominantly seen . recent and remote memory loss. Impaired judgement seen , it is due to intellectual deficit due to brain changes

Both conditions have similarties like, lake of interst, social withdrawal, memeory loss, difficulty in concentration, self confinement, apathy, insomnia, fatigue, loss of energy, suicidal ideation, irritability, Yet, some of the features are vary.

Feeling of hopelessness, helplessness, worthlessness are intense in depressed client.But less severe in dementia.

Both have episodes of depression, in dementia it is on and off

Client with dementia not talk too much about suicide.

Agitation seen in delerium, but it is sudden onset.

Misperception common in delerium like illusion, hallucianations, delusion. in demetia it is abscent. in depression it present.

While doing assessment , person with dementia, distracted from task, in dementia, people will strugle to identify answers, but person's with depression try to escape, always say don't know.