This health condition is most common in older adults at the hospital; 1 in 3 hospitalized adults over age 70 have it. However, anyone can experience delirium, even if it’s less widespread.
Delirium is a very serious condition, but the good news is that it’s often temporary. Treatment is administered depending on the cause, be it illness, medication side effects, or infection.
So you already know that hospitalization and age can increase one’s risk of developing delirium. But there are also a few other factors, namely:
Confusion is considered the primary symptom of delirium. Practically, this symptom manifests itself through:
In addition, individuals going through delirium may display:
Symptoms appear rather rapidly – within hours or days, and they fluctuate throughout the day. In general, a person experiencing delirium may also feel better during the day, but get worse at night when the surroundings look more unfamiliar.
As you may have noticed, some of these symptoms contradict each other. That’s because delirium can make a person more active, less active, or have them ping-pong between hyperactivity and reduced activity. That’s why doctors typically distinguish between the following three types of delirium:
Hypoactive delirium is the flip side of the previous type, as it is accompanied by a reduced level of activity. Individuals with this type of delirium appear sluggish, unable to concentrate, and appear to be in a daze. They may also have a blank facial expression while speaking or display no interest in the surroundings. Movements may become slower, they may sleep more, miss meals, and seem quiet and withdrawn.
As the name indicates, this type combines the features of the previous two types. A person may switch back and forth between hyperactive and hypoactive delirium. Generally, you may not see a change in activity level, but the person will display hyperactive symptoms, like agitation, and then return to hypoactive symptoms by sleeping all day.
These two conditions are often confused because they are similar on the surface. Even though both delirium and dementia involve confusion and memory issues as a symptom, there are several key differences between these two conditions.
The primary difference is the rapid onset. Delirium begins quickly and abruptly, whereas a person with dementia will generally get worse over a long period of time, often years. Another feature of delirium are the fluctuations between periods of alertness and confusion during the day. In contrast, dementia is a more constant reduction in cognitive abilities. The memory issues tend to be different too: while dementia patients have long-term memory problems, delirium patients have issues with short-term memory.
The video below shows an easy-to-memorize mnemonic to help differentiate between the two conditions:
Note: It is possible to have both dementia and delirium at the same time. In fact, dementia increases the risk of delirium, whereas delirium can speed up the progression of dementia.
There is rarely, if ever, a single cause of delirium. It develops when the body’s compensatory mechanisms can no longer stand up to a multitude of stressors. These mechanisms are also called functional reserve capacity, and it is vulnerable to a variety of stressors, such as:
When not treated promptly, delirium can result in complications of various durations and severity. A few examples are:
Once the underlying trigger of the delirium episode is addressed, the person should start recovering. The better one’s health before developing delirium, the faster and greater the degree of recovery.
In case someone you know who is not in the hospital exhibits signs of delirium, try to get them to the hospital as soon as possible. Severe symptoms of delirium or their rapid development require emergency treatment.
During the doctor’s visit, they will use a combination of a physical and neurological exam. Some lab tests may also be required. If you’re visiting with a loved one, it’s a smart idea to record the changes in behavior you are seeing.
Unlike a progressive brain condition like dementia, delirium is treatable. The time for full or partial recovery ranges from hours to days and even months. Recovering from this condition takes time, and some changes may be permanent. The faster one gets treatment, and the milder the delirium, the quicker the recovery will be.
Improving your general health and staying active can significantly reduce your risk of delirium, or even prevent it altogether. Here are several preventative tips that will help you avoid this scary condition:
1. Do regular mental exercises – be it online quizzes, crossword puzzles, or simply make sure that you know the date and time at all times.
2. Let natural light in during the day, and keep the room dark at night. This will help the brain stay oriented in time.
3. Use hearing aids and glasses if you need them. It’s important to stimulate vision and hearing processing in the brain about your surroundings.
4. Move around as much as you can, exercise, or do physical therapy the moment your doctor allows you to do so. Just make sure to do so safely and with guidance if necessary to prevent injuries and falls.
5. Connect with family and loved ones as much as you can.
6. Go to regular delirium assessments.
Delirium tremens happens due to withdrawal from daily alcohol use. It causes confusion along with tremors, particularly shaking hands. Other symptoms include:
When it occurs, the person experiencing it needs emergency medical care. Untreated delirium tremens is deadly in 37% of cases, so timely treatment could be life-saving.
References: Cleveland Clinic, Verywell Mind, Healthline, Better Health While Aging, Medical News Today
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