Overview
The Clinical Distinction
A patient described as “confused” needs a time course, an attention assessment and an arousal assessment before the nurse assigns a diagnosis or explains the behaviour.
A patient described as “confused” needs a time course, an attention assessment and an arousal assessment before the nurse assigns a diagnosis or explains the behaviour. | Feature | Delirium | Dementia (major neurocognitive disorder) | |---|---|---| | Onset | Hours to days | Usually months to years | | Course | Fluctuates, often worsening and easing during the same day | Relatively stable from day to day, with gradual decline | | Attention and arousal | Inattention is central; the patient may be drowsy, hyperalert or shift between both | Usually preserved until advanced disease | | Cognition | New impairment in orientation, memory, language, perception or visuospatial function | Persistent decline in one or more cognitive domains that interferes with function | | Relationship to illness | Attributable to an acute medical condition, medication, substance or withdrawal, or several factors | Usually reflects an underlying neurodegenerative, vascular or other chronic disorder | | Immediate priority | Find and correct the physiological trigger | Support function, safety, autonomy and caregivers | Delirium occurs when the brain can no longer...