Delirium and Dementia

1. Delirium and Dementia Dr. Ravichandra Karkal Assistant Professor of Psychiatry Yenepoya University

2. Introduction • Cognition includes memory, language, orientation, judgment, conducting interpersonal relationships, performing actions (praxis), and problem solving. • Cognitive disorders

3. Neurology, Medicine, Psychiatry • Behavioral symptoms • Organic vs. Functional • Neuropsychiatry

4. 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

5. Synonyms • Intensive care unit psychosis • Acute confusional state • Acute brain failure • Sundowning • Cerebral insufficiency • Organic brain syndrome

6. 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

7. Types of delirium • Hypoactive vs Hyperactive delirium • EEG findings

8. Treatment • Reorientation • Clear instructions • Judicious use of restraints • Identification and correction of inciting cause • Agitation/ Insomnia- Antipsychotics, Benzodiazepines

9. Delirium vs Dementia • Onset • Duration • Attention • Speech • Sleep

10. Dementia • Dementia is defined as a progressive impairment of cognitive functions occurring in clear consciousness.

16. Management

18. THANK YOU