Peer Response-Comparison of Dementia and Delirium 

Peer Response-Comparison of Dementia and Delirium 

Responding to Jacqueline

Hello Jacqueline,

This is a very intriguing post! Your detailed comparison of dementia and delirium is insightful and well-organized. I appreciate the thoroughness with which you addressed each component, providing a comprehensive view of the clinical presentation, pathophysiology, assessment, diagnosis, and management of both disorders. Your inclusion of demographic differences, such as the higher prevalence of dementia in older women and delirium’s greater occurrence in elderly males with medical comorbidities, adds a valuable dimension to the discussion (Gogia & Fang, 2023).

I found your explanation of the pathophysiology of dementia and delirium to be particularly informative. While the exact cause of dementia remains elusive, your mention of potential risk factors like family history, heart disease, and diabetes contributes to a better understanding of the condition (Gogia & Fang, 2023). Similarly, attributing delirium to an inflammatory response and cholinergic neurotransmitter deficiencies sheds light on its complex nature. Further, your emphasis on the importance of a complete physical examination for delirium, including mental status and vital signs, is crucial in the assessment section. This holistic approach aligns with the dynamic and fluctuating nature of delirium symptoms. Additionally, including a wide range of diagnostic tests for both disorders showcases your attention to detail and thorough approach to patient evaluation.

I would like to add that considering the socio-cultural aspects of care might also be beneficial, especially in dementia, where family dynamics and support systems play a significant role (Häikiö et al., 2019; Oh et al., 2019). Exploring the impact of cultural factors on the management and follow-up care could enhance the overall understanding of these conditions. Overall, your post is comprehensive and well-researched, contributing significantly to our understanding of dementia and delirium.

References

Gogia, B., & Fang, X. (2023). Differentiating delirium versus dementia in the elderly. StatPearls – NCBI Bookshelf. https://www.ncbi.nlm.nih.gov/books/NBK570594/

Häikiö, K., Sagbakken, M., & Rugkåsa, J. (2019). Dementia and patient safety in the community: A qualitative study of family carers’ protective practices and implications for services. BMC Health Services Research, 19(1). https://doi.org/10.1186/s12913-019-4478-2

Oh, S., Yu, M., Ryu, Y. M., Kim, H., & Lee, H. (2019). Changes in family dynamics in caregiving for people with dementia in South Korea: A qualitative meta-synthesis study. Qualitative Health Research, 30(1), 60–72. https://doi.org/10.1177/1049732319871254

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respond to Jacqueline

Dementia and Delirium

Delirium and dementia are the most common causes of altered mental status in the elderly and can be difficult to differentiate. In this discussion compare the two.

Peer Response-Comparison of Dementia and Delirium

Presentation

Demographics
Dementia: Typically presents in the older population 65 and older. Almost 2/3 of Americans with dementia are women. Black women are twice likely than white women to have dementia, and Hispanic women are one- and one-half times as likely to have dementia than older white women (Alzheimer’s Association, 2023).
Delirium: Most observed in elderly male patients greater than 65 years of age, but less than female patients who are greater than 85 with medical comorbidities. There is no racial predilection for delirium (Serpytis et al., 2017).
Onset of symptoms
Dementia: Cognitive changes such as trouble understanding spoken and written communication, psychiatric symptoms such as depression, insomnia, and hallucinations, personality changes including frustration and social withdrawal, problem behaviors like wandering and restlessness, and finally changes in the day-to-day functioning (Santacruz & Swagerty, 2001).
Delirium: Sudden or quick presentation of incoherent thinking, auditory and or visual hallucinations, and agitation, resulting in confused thinking and lack of awareness that may fluctuate throughout the day (Mart et al., 2021).
History of present illness
Dementia: A 66-year-old female comes in as a new patient with her husband who reports problems with memory such as misplacing keys, and forgetting common words when speaking which has gradually worsened over the last year or so.
Delirium: A 72-year-old male who is s/p hip replacement surgery 2 days ago develops acute confusion, lip biting, and rapid speech.
Associated risk factors
Dementia: Cardiovascular disease, physical inactivity, renal dysfunction, diabetes, high cholesterol, smoking, obesity, hypertension, and depression (Vrijsen et al., 2021).