Dementia vs Delirium

Navigating the complexities of mental health can be challenging, especially when dealing with conditions that affect cognitive functions. Two such conditions—dementia and delirium—often get confused due to overlapping symptoms. However, understanding their key differences is crucial for proper diagnosis and treatment. It is important to understand that dementia and delirium are two distinct conditions with different management and treatments. [1] Mistaking the two is a common clinical mistake. In this blog post, we will explore these differences in detail to help clarify these often misunderstood conditions.

Key Differences

In instances of reversible dementia and chronic delirium, this difference becomes hazy. While dementia is characterized as cognitive deterioration interfering with one or more areas, delirium is characterized by altered awareness primarily impairing attention. [3] Unlike dementia, which develops gradually and affects basic traits and attention much later in the illness, delirium is characterized by an abrupt start of impaired orientation or awareness to the environment. [6]

In older people, the two coexist frequently; in cases when dementia is progressing quickly, this also happens. [2] In people who have never experienced dementia before, it might be challenging to distinguish between the two. It becomes crucial to differentiate between the two as a result. [5]

In addition to differentiating delirium from dementia, it is important to recognize superadded delirium in a patient who already has dementia since it increases hospital stays, accelerates cognitive and functional deterioration, raises healthcare expenditures, and ultimately results in death.[6] In almost thirty percent of instances, delirium is avoidable. [4]

Research has demonstrated a two to four times higher mortality rate in patients experiencing delirium in the intensive care unit (ICU) and 10 tens higher risk of death one year after discharge from general medical wards, geriatric services, and nursing homes with comorbidities, such as stroke. [7]

Symptoms Comparison

The symptoms of dementia include:

• Gradual memory loss
• Difficulty with complex tasks
• Impaired reasoning or judgment
• Slow decline in cognitive abilities
• Personality changes

In contrast, delirium manifests with:

• Sudden confusion
• Disrupted attention and awareness
• Hallucinations and delusions
• Dramatic shifts in mood
• Fluctuating levels of consciousness

Seating Matters Atlanta Chair

We have found Seating Matters Atlanta chair works exceptionally well for patients with non-cognitive symptoms of dementia an

d those experiencing delirium. It is my experience that when the patient relaxes and feels safe, their muscle tone reduces. This reduces the risk of th

e development of pressure injuries and contractures and reduces pain, so they are able to engage in functional activities.

The benefits of the Atlanta chair for the patient with dementia or delirium include:

+ Providing proprioceptive feedback for the whole body.

+ Tilt and recline feature and high armrests which provides a cocooning feeling and sense of safety.

+ Easy to maneuver, which allows users to remain more sociable and prevents them from being confined to one place at a time. Decreases frequency of transfers.

+ Low seat to floor height reduces the risk of falls and injury in event of a fall.

+ Helps increase comfort, reduces agitation, and promotes relaxation.

How can clinical, therapeutic seating help people with Dementia and delirium?

+ Reducing falls and sliding.

+ Reducing risk of pressure injuries, high muscle tone and contractures.

+ Reducing pharmacological interventions for pain or agitation

+ Improving the patients’ function and reducing nurse/carers input.

+ Increasing time spent out of bed.

+ Reducing level of distress by reducing the frequency of transfers

+ Providing sensory information by giving proprioceptive feedback

The importance of clinical seating for people living with dementia is clear. From optimising physical comfort and independence to facilitating social interaction and to sensory inform, therapeutic seating greatly contributes to the overall wellbeing of individuals living with dementia. These benefits have also been seen with patients experiencing delirium.

By recognising the significance of clinical seating and acknowledging its potential impact, caregivers and healthcare professionals can embrace this essential component of caring for those with cognitive impairment, enhancing the quality of life for the person with dementia or experiencing delirium and their families.

We are here to help you have all the information you need to help you to get it right first time. Call us for advice and support or book a free Seating Assessment with team of expert Seating Specialists.

References

1. Han JH, Suyama J. Delirium and Dementia. Clin Geriatr Med. 2018 Aug;34(3):327-354. [PubMed]

2. Ramírez Echeverría MDL, Schoo C, Paul M. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Nov 19, 2022. Delirium. [PubMed]

3. Emmady PD, Schoo C, Tadi P. StatPearls [Internet]. StatPearls Publishing; Treasure Island (FL): Nov 19, 2022. Major Neurocognitive Disorder (Dementia) [PubMed]

4. Fong TG, Davis D, Growdon ME, Albuquerque A, Inouye SK. The interface between delirium and dementia in elderly adults. Lancet Neurol. 2015 Aug;14(8):823-832. [PMC free article] [PubMed]

5. Fick DM, Agostini JV, Inouye SK. Delirium superimposed on dementia: a systematic review. J Am Geriatr Soc. 2002 Oct;50(10):1723-32. [PubMed]

6. Oh ES, Fong TG, Hshieh TT, Inouye SK. Delirium in Older Persons: Advances in Diagnosis and Treatment. JAMA. 2017 Sep 26;318(12):1161-1174. [PMC free article] [PubMed]

7. Inouye SK, Westendorp RG, Saczynski JS. Delirium in elderly people. Lancet. 2014 Mar 08;383(9920):911-22. [PMC free article] [PubMed]