Early Detection and Diagnosis of Delirium in Elderly Patients

It is often difficult to distinguish between delirium in the elderly and forms of dementia. Both diagnoses may present in similar ways and delirium is also a medical condition that often results in cognitive changes. Delirium, like dementia, may cause symptoms such as agitation and confusion that may increase during evening hours. However, delirium usually appears more suddenly and over a shorter period of time than dementia. It is important to know the associated risks and its possible causes when making a proper diagnosis of delirium.

Delirium is an acute state of confusion that requires immediate attention. Delirium is usually caused by a number of factors that may result in changes in normal brain activity. Possible causes may be due to medications or drug toxicity. Alcohol or drug abuse may also relate to increased confusion. A medical condition, fever, dehydration, malnutrition, sleep deprivation, and pain may accompany states of delirium. Patients may also experience confusion from anesthesia following surgery or a medical procedure. A large risk factor for delirium is a hospital stay often associated with a stay in the intensive care unit of a hospital. It is important to recognize that confusion is not a normal part of aging and even thought the brain ages with the rest of the body; cognitive function will not automatically decline with age (Plata & Hamrick-King, 2006).

It is helpful to know how to determine the differences between delirium and dementia. There are a number of screening tests that can be utilized to differentiate between delirium and dementia. The Confusion Assessment Method (CAM) is a tool that can help find a diagnosis of delirium and requires the presence of acute onset and fluctuations in cognition and inattention. There must also be the presence of either disorganized thinking or changes in alertness, consciousness or ability to process information. This assessment can be administered by most clinicians. Another assessment tool often used is the mini-cog where the individual is asked to recall certain words and engage in a clock drawing test.

It is important for family members, caregivers and professionals to quickly identify signs of delirium so that interventions can be employed. Routine diagnoses of pneumonia, a urinary tract infection, or even constipation may result in increased confusion and changes in cognition. Early recognition is important so that further deterioration does not result. Often times the sooner delirium is diagnosed the quicker it can be resolved with medical intervention. Knowledge is always power when learning how to recognize cognitive changes in your loved one. To learn more about recognizing the signs of delirium, contact us today.