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Learn about the differences between delirium and dementia, their symptoms, predisposing factors, and treatment options. Gain insights into cognitive disorders from a psychiatric perspective.
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Delirium and Dementia Dr. Ravichandra Karkal Assistant Professor of Psychiatry Yenepoya University
Introduction • Cognition includes memory, language, orientation, judgment, conducting interpersonal relationships, performing actions (praxis), and problem solving. • Cognitive disorders
Neurology, Medicine, Psychiatry • Behavioral symptoms • Organic vs. Functional • Neuropsychiatry
Delirium • Delirium is a syndrome defined by the acute onset of fluctuating cognitive impairment and a disturbance of consciousness. • Sudden onset (hours or days), a brief and fluctuating course, and rapid improvement when the causative factor is identified and eliminated
Synonyms • Intensive care unit psychosis • Acute confusional state • Acute brain failure • Sundowning • Cerebral insufficiency • Organic brain syndrome
Predisposing factors • Substance abuse/withdrawal • Cognitive impairment • Older age >70 years • Visual impairment • ICU setting • Malnutrition/Dehydration • Electrolyte disturbance (Na+, K+) • Multiple medical illness and medications
Types of delirium • Hypoactive vs Hyperactive delirium • EEG findings
Treatment • Reorientation • Clear instructions • Judicious use of restraints • Identification and correction of inciting cause • Agitation/ Insomnia- Antipsychotics, Benzodiazepines
Delirium vs Dementia • Onset • Duration • Attention • Speech • Sleep
Dementia • Dementia is defined as a progressive impairment of cognitive functions occurring in clear consciousness.