Delirium is when an individual experiences sudden confusion or change in mental status, oftentimes acting disoriented or distracted.
Delirium and Alzheimer’s disease or dementia-related disorders have some similarities, but they are not the same.
For instance, delirium mostly affects a person's attention, while dementia affects memory. Delirium begins suddenly while dementia is long-term confusion that usually begins gradually and worsens over time.
However, someone can have both delirium and dementia.
Hyperactive and hypoactive delirium are two common types of delirium.
Those with hyperactive delirium, occurring in up to 75% of those with delirium, become overactive, agitated and restless. They may have rapid changes in emotion, have trouble concentrating and experience hallucinations or anxiety.
Those with hypoactive delirium are underactive, sleepy and slow to respond. There is a sense of withdrawal and apathy.
Individuals can also experience both types of delirium together. Symptoms of delirium usually improve in a few days to weeks, depending on any underlying medical conditions.
According to the Cleveland Clinic, delirium happens more often in older adults and hospitalized patients. “Hospital delirium” can affect 10% to 30% of those patients.
Additionally, those with high-risk health condition may develop delirium: 80% of people who are at end of life; those who have had surgery; 70% of those in intensive care; 60% of people over age 75 in nursing homes; 30% to 40% of those who have HIV; and 25% of people with cancer.
It is sometimes difficult for health care providers to pinpoint the exact cause of the delirium. Some known causes are alcohol/drug toxicity; reactions to pneumonia; sepsis or urinary tract infections; changes in environment; dehydration; medications; thyroid issues; hospitalization; kidney or liver failure; insomnia; and pain.
A physician will look for changes in the individual to determine a diagnosis of delirium. An example of such changes is if someone is displaying noticeable changes in focus and has a rapid onset of thinking problems, which change during the course of the day. The physician will also perform a physical exam as well as blood and urine tests and possible imaging tests such as X-rays, CT or MRI scans.
Because other medical conditions usually cause delirium, the physician will also review the person's medical history and his or her use of alcohol and/or illicit drugs. Treatment of delirium depends on the cause and may include antibiotics, fluids for dehydration, antipsychotic drugs or benzodiazepines for alcohol/drug use withdrawal.
It helps to focus on the environment when caring for someone with delirium. A quiet setting is best, along with helping them develop consistent sleep habits by keeping him or her awake during the day and by avoiding naps. Good nutrition is a must as well as making sure the individual drinks lots of fluids. Simple movement, such as short walks, is beneficial as well as any kind of mental stimulation. Above all, the person experiencing delirium needs constant reassurance and things around him or her that are familiar, such as a special blanket, photos or mementos.