Delirium and Dementia

Question 1

Diagnosis of delirium

Answer 1

Confusion Assessment Method (CAM)
Feature 1: Acute Onset and Fluctuating Course
Usually acquired information from a family member or nurse. Is there evidence of an acute change in mental status from the patient’s baseline? Does that behaviour fluctuate during the day?
Feature 2: Inattention
Does the patient have difficulty focusing their attention, being easily distractible, or having difficulty following the conversation?
Feature 3: Disorganized thinking
Was the patient’s thinking disorganized or incoherent, such as rambling or irrelevant conversation, unclear or illogical flow of ideas with a change from subject to subject?
Feature 4: Altered Level of consciousness
This feature is shown by any answer other than “alert” to the following question:
Overall, how would you rate this patient’s level of consciousness? (alert [normal]), vigilant [hyperalert], lethargic [drowsy, easily aroused], stupor [difficult to arouse], or coma [unarousable])

The diagnosis of delirium by CAM requires the presence of features 1 and 2 and either 3 or 4 (or both).

Question 2

Characteristic symptoms of delirium

Answer 2

Characteristic symptoms
fluctuating confusion and clouding of consciousness
\+/- 
Poor concentration
poor memory
disordientation
inattention
agitation
emotional upset
hallucinations, vision or illusion
suspiciousness 
disturbed sleep

Question 3

Symptoms progression of alzheimers

Answer 3

1- Memory loss
2 - confusion, poor judgement
3 - language and thoughts, restlessness, agitation
4 - inability, dependence on others for care
5 - wt loss, seizures, loss of bladder and bowel control
6 - infection, groaning, moaning, or grunting
7 - Death usually occurs from aspiration, pneumonia, respiratory, failure or septicaemia