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Understanding the Three Ds: Dementia, Delirium, and Depression

Monday , March 22 , 2021

Understanding the Three Ds: Dementia, Delirium, and Depression

Older adults are at high risk for depression and cognitive disorders such as dementia and delirium. Clarifying the diagnosis is the first step to effective treatment – but it’s not always easy. 

Delirium and depression can cause cognitive changes that may be mistaken for dementia, such as poor memory. And people who have dementia often develop signs of depression, like poor appetite and low self-esteem. 

There is also the genuine possibility that an older adult may have a combination of all three issues concurrently. 

So, how can you tell the difference between dementia, delirium, and depression in older people, to ensure they receive the proper care? Keep reading to learn more about the signs and symptoms of each condition. And make sure to sign up for our “Understanding the 3 Ds” webinar at the bottom! 

Delirium

Delirium is a neuropsychiatric syndrome that causes sudden changes to a person’s thinking and attention, causing them to become confused. Episodes of delirium are common among older adults, especially those who are ill, in the hospital, or recovering from surgery. The condition develops acutely and is temporary and reversible. 

The most common symptom is inattention, though a person experiencing delirium may also suffer from difficulty with orientation, memory, or language and thought. Hallucinations or illusions may also be present. 

Depression

Depression is a common mood disorder. In fact, according to the World Health Organization, over more than 264 million people suffer from the illness, and it’s the leading cause of disability worldwide. 

The diagnosis of depression depends on the presence of two main symptoms: persistent and pervasive low mood and loss of interest or pleasure in usual activities. Other signs include: 

  • Increased fatigue and sleep problems
  • Anxiety
  • Irritability (primarily in men)
  • Changes in appetite or weight
  • Uncontrolled emotions

Symptoms are of clinical significance when they interfere with everyday activities and last for at least two weeks. 

Along with apathy, depression is one of the most common symptoms in Alzheimer’s Disease – especially those with Lewy bodies. 

Dementia

Dementia is not a single disease but an umbrella term covering a wide range of medical conditions, including Alzheimer’s. According to the National Institute on Aging, “Dementia is the loss of cognitive functioning—thinking, remembering, and reasoning—and behavioral abilities to such an extent that it interferes with a person’s daily life and activities.”

Signs of dementia can vary greatly, but some common examples include: 

  • Problems with short-term memory
  • Increased confusion
  • Reduced concentration
  • Personality or behavior changes
  • Depression or apathy

Complications in Diagnosis

Symptoms of delirium, depression, and dementia can be pretty similar. For instance, delirium and depression may present with apathy and withdrawal, while delirium and dementia are characterized by confusion and disorientation. 

To further complicate matters, delirium and depression often occur in a person with dementia, so it is common to have all three issues at once. 

Differentiating delirium from depression and dementia requires knowing the characteristic features of each condition and knowing the patient’s history (either personally or from a family member or friend). 

The Victoria State Government has a helpful chart with a side-by-side analysis of all three conditions and their key features. 

Attend a FREE ComForCare Workshop

ComForCare is offering a free virtual workshop on Wednesday, March 31st, from 1:00 pm – 2:30 pm. 

The workshop entitled “Understanding the 3 Ds: Dementia, Delirium, and Depression” will count as one continuing education credit for social workers and case managers and 1.5 contact hours for RNs/LPNs.

By the end of the program, participants will be able to: 

  • Distinguish between dementia, delirium, and depression and the causes and prevalence of each
  • Recognize the signs and symptoms that overlap across all three conditions, as well as the differences that set them apart
  • Identify common scenarios in which combinations of conditions may occur
  • Explain why people need a thorough evaluation of any changes in mental status, including those already diagnosed with dementia
  • Take the appropriate actions to connect families and individuals to evaluations and resources if dementia, delirium, or depression are suspected

Go to bit.ly/delirium2021 to sign up today! 

Posted in: Aging