6.6 Delirium

Question 1

What are some clinical features of delirium?

Answer 1

• Disturbed cognition
• Onset over hours/days
• Fluctuation (esp. nocturnal)
• Interrupted sleep-wake cycle
• Abnormal psychomotor behaviour (hypo/hyperactive)
• Agitation

Question 2

Onset time of dementia vs delirium

Answer 2

Dementia: longer onset
Delirium: shorter (hours - days)

Question 3

Define delirium

Answer 3

Delirium is a state of acute confusion marked by fluctuating consciousness, memory problems, disorientation, and changes in behavior.

Question 4

What cause should you ALWAYS think about for delirium?

Answer 4

Drugs. Esp. new drugs

Question 5

List some drugs that are especially likely to cause delirium

Answer 5

• Benzos
• Prednisolone
• Pain relief
• Chemo

Question 6

List a bunch of causes of delirium

Answer 6

PINCH ME:

P: Pain
In: Infection
C: Constipation
H: Hydration (electrolyte imbalance)
M: Medication
E: Environment (sleep deprivation?)

Question 7

How does delirium threshold change as we get older?

Answer 7

• It decreases
• More likely to become delirious with smaller insult

Question 8

Sleep wake cycle in dementia vs delirium

Answer 8

Dementia: normal
Delirium: disrupted

Question 9

Consciousness in dementia vs delirium

Answer 9

Dementia: normal
Delirium: depressed

Question 10

Attention in dementia vs delirium

Answer 10

Dementia: normal
Delirium: impaired

Question 11

Agitation/fear vs apathy/disinhibition; which indicates dementia/delirium?

Answer 11

Dementia: apathy/disinhibition

Delirium: agitation/fear

Question 12

Dementia vs delirium vs depression

Answer 12

• Onset (delirium acute)
• Underlying cause (del: drugs/infections etc., dem: neurodegenerative, dep: genetic, biological etc.