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dementia vs delirium vs depression
Clinical manifestations:
1) onset
- dementia: insidious
- delirium: acute or subacute
- depression: variable, often abrupt
2) duration
- dementia: chronic, progressive, months to years
- delirium: hours-days, up to one month
- depression: week to months to years
3) fluctuations
- dementia: constant, irreversible
- delirium: abnormal day-night cycle, reversible with treatment
- depression: reversible with treatment
4) kineses
- dementia: normal to lethargy
- delirium: abnormal movement, lethargy to agitated
- depression: normal to lethargy
5) attention
- dementia: shortened attention span
- delirium: impaired, fluctuating attention span
- depression: attention span normal, but easily distracted
6) arousal
- dementia: normal
- delirium: disturbed arousal, (clouding of consciousness)
- depression: sensorium is clear
7) memory
- dementia: abnormal
- delirium: impaired recent & immediate memory
- depression: selective memory impairment
8) speech/language
- dementia: anomic or worse
- delirium: dysarthric/misnaming
- depression: normal
9) speech content
- dementia: empty or sparse
- delirium: confused (incoherent)
- depression: sad or empty
10) cognition:
- dementia: difficulty with abstraction, problems, word finding; confabulation
- delirium: thinking is disorganized, distorted
- depression: intact thinking, but expresses hopelessness or helplessness
11) perceptual
- dementia: normal to moderately abnomal
- delirium: prominently abnormal (clouded sensorium)
- depression: normal
12) hallucinations:
- dementia: uncommon
- delirium: visual > auditory
- depression: no
13) EEG
- dementia: normal to moderately slow
- delirium: diffusely slow
- depression: normal
Related
delirium (acute confusional state)
dementia; Alzheimer's disease & related dementias (ADRD)
References
- Mendez, M. Comprehensive Geriatric Assessment, Osterweil et
al eds, McGraw Hill, New York, 2000, pg 88
- Foreman, M et al,
Assessing cognitive function
Geriatric Nursing 1996; 5:100