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NR 603 WEEK 1 COMPARISON AND CONTRAST ASSIGNMENT (02 VERSIONS)
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NR 603 WEEK 1 COMPARISON AND CONTRASTASSIGNMENT (02 VERSIONS)
Dr. Julian and classmates,
For the purpose of this assignment, I will be comparing and contrasting dementia and delirium
which is the topic I was assigned this week. I will review a basic presentation of both diseases/conditions
including a review of demographics, onset of symptoms and associated risk factors. I will also review the
pathophysiology, assessment findings, diagnostic testing, diagnosis and treatment according to national
guidelines for both conditions.
Presentation of Dementia and Delirium
Major Neurocognitive Disorder or more commonly known as Dementia, is a collection of
symptoms that are caused by a number of disorders that affect the brain (Hollier, 2018). Causes of
dementia include but not limited to Alzheimer’s Disease, Vascular Disease, Frontotemporal Lobar
Degeneration, Lewy Body Disease, Parkinson’s Disease, Traumatic Brain Injury, Huntington Disease,
infection, Prion Disease, and Creutzfeldt-Jakob Disease (Hollier, 2018; Schub & Smith, 2018). The most
common cause of dementia is Alzheimer’s disease which accounts of 60 to 80% of all dementia cases
(Hollier, 2018). It was estimated that over 35 million people had dementia in 2010 across the world and
50 million people in 2017 with the prevalence expected to double every 20 years which would mean
about 65 million cases in 2030 and 115 million cases in 2050 (ASLHA, 2019; Morandi et al., 2018). These
numbers are just so shocking to me! Dementia is way more common than I had originally thought.
According to the DSM-V, criteria for diagnosis of dementia can be made if there is a cognitive
impairment from baseline functioning in one or more of the following areas: language, memory,
executive function, attention, purposeful movement and social cognition (American Psychiatric
Association, 2013; Hollier, 2018). Some patients with dementia cannot control their emotions and
therefore their personality may change (National Institutes of Aging, 2017). Symptoms range based on
the severity of dementia with the mildest stage presenting with mild effects on a person’s functioning to
the most severe stage were the person may become dependent on others for total care of basic ADLs.
Dementia has a slow insidious onset that progressively and chronically gets worse that varies from
months to years with no cure unlike delirium (Schub & Smith, 2018).
Delirium has an abrupt onset that develops over hours or days and can typically change
throughout the day known as sundowning and is characterized by a sudden deterioration in cognitive
status with a disturbed level of consciousness (Schub & Smith, 2018). Delirium is an alternation in brain
function caused by an illness or physical condition. Delirium is considered a medical emergency since it
has been associated with many poor medical outcomes; however, it is not terminal like dementia, but
instead is reversible. Delirium can occur at any age, but it is more common in the older adult population
and in ICU settings with underlying causes. It was shocking to discover that half of all patients in the ICU
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