Delirium vs Dementia

Key points

• Delirium: ACUTE onset, fluctuating course, impaired consciousness/attention, often reversible cause (infection, drugs, hypoxia, metabolic).
• Dementia: insidious onset over months/years, clear consciousness, progressive cognitive decline.
• Delirium is more common in dementia patients — screen with the 4AT or CAM tool.
• Delirium management: find and treat the underlying cause; avoid sedatives where possible (haloperidol only if severe distress/risk).
• Delirium tremens: withdrawal delirium with autonomic overactivity (see alcohol chapter).

Decision points in this pathway

• Managing delirium

The full step-by-step algorithm, including what to do at each branch, opens in the app for approved members.