Delirium vs. Dementia vs. Depression

Delirium vs. Dementia vs. Depression

Condition	What is it? (정의)	Key Signs & Symptoms (주요 증상)	Safety Concerns (안전 유의점)	Tests / Treatments (검사 / 치료)	Common Treatments (일반적 치료)
Delirium (섬망)	Sudden, temporary confusion caused by illness, meds, or imbalance. (갑작스럽고 일시적인 의식·정신 혼란, 주로 질병·약물·불균형으로 발생)	- Sudden onset (급성 발병)- Fluctuates (오르락내리락 변동)- Poor attention (집중력 저하)- Disorganized thinking (사고 혼란)- May have hallucinations (환각 가능)	- High fall risk (낙상 위험 ↑)- May remove IV, wander (의료기기 제거, 배회)- Needs calm environment (안정된 환경 필요)	- Labs, urine test, med review, imaging (혈액·소변 검사, 약물검토, 영상검사)- Treat underlying cause (원인 치료)	- Antibiotics (항생제), fluids (수액)- Adjust medications (약물 조정)- Reorientation, reassurance (재지향·안심 제공)
Dementia (치매)	Slow, progressive, irreversible decline in memory & thinking. (서서히 진행되는 기억·사고 능력 저하, 대부분 비가역적)	- Gradual onset (서서히 발병)- Memory loss (기억력 저하)- Language/reasoning problems (언어·추론 장애)- Personality changes (성격 변화)	- Risk of wandering (배회 위험)- Forget meds, stove, meals (약·가스·식사 잊음)- Vulnerable to abuse (학대 위험)	- Cognitive tests (인지검사: MMSE, MoCA)- Bloodwork, brain imaging (혈액·뇌영상검사)- Rule out reversible causes (가역적 원인 배제)	- Meds: donepezil, rivastigmine, memantine (약물치료)- Safe environment (안전한 환경)- Caregiver support (간병인 지원)
Depression (우울증)	Mood disorder with sadness, loss of interest, low energy. (지속적 우울감, 흥미·에너지 저하를 보이는 기분장애)	- Sadness, hopelessness (슬픔·절망)- Withdrawn, low energy (무기력·사회적 위축)- Sleep/appetite changes (수면·식욕 변화)- May look like memory loss (기억장애처럼 보임)	- Risk of self-harm/suicide (자해·자살 위험)- Poor self-care (자기 관리 부족)- Needs emotional support (정서적 지지 필요)	- Depression scales (우울척도 검사: GDS 등)- Labs to rule out other causes (혈액검사)- Therapy/medications (치료·약물)	- SSRIs (항우울제: sertraline, citalopram 등)- Counseling/therapy (상담·치료)- Exercise, social activity (운동·사회활동)

 

 

 

 

 

 

Quick Memory Aid (암기 팁):

• Delirium (섬망) = Sudden, fluctuates, reversible (갑작스럽게, 변동, 가역적)
  
  
• Dementia (치매) = Slow, progressive, irreversible (서서히, 진행, 비가역적)
  
  
• Depression (우울증) = Mood-based, can mimic dementia, treatable (기분 문제, 치매처럼 보일 수 있음, 치료 가능)
  
  

 

 

 

 

 

 

 

 

 

 

 

Delirium

What is it?

• A sudden, temporary change in mental status (confusion, trouble paying attention, disorganized thinking).
  
  
• Usually caused by something reversible (infection, medications, electrolyte imbalance, etc.).
  
  

Key Signs & Symptoms

• Sudden onset (hours to days)
  
  
• Fluctuates during the day (better/worse)
  
  
• Poor attention & focus
  
  
• Disorganized thinking, speech changes
  
  
• Hallucinations or agitation sometimes
  
  

Safety Considerations

• High fall risk (confused, restless)
  
  
• May pull out IVs, lines, or wander
  
  
• Needs frequent reorientation, calm environment
  
  

Tests/Treatments Ordered

• Tests: bloodwork, urinalysis, CT if needed, medication review
  
  
• Treatments: treat underlying cause (infection, dehydration, med change), supportive care
  
  

Common Treatments

• Correct cause (antibiotics, fluids, adjust meds)
  
  
• Quiet environment, familiar objects
  
  
• Reassurance & reorientation
  
  

 

 

 

 

 

 

 

 

 

 

Dementia

What is it?

• A slow, progressive decline in memory, thinking, and problem-solving.
  
  
• Usually irreversible (ex: Alzheimer’s disease).
  
  

Key Signs & Symptoms

• Gradual onset (months to years)
  
  
• Memory loss, especially recent memory
  
  
• Trouble with language, reasoning, problem-solving
  
  
• Personality/behavior changes over time
  
  

Safety Considerations

• Risk of wandering & getting lost
  
  
• Forgetting to eat, take meds, or turn off stove
  
  
• Vulnerable to abuse/exploitation
  
  

Tests/Treatments Ordered

• Tests: Cognitive assessments (MMSE, MoCA), blood tests to rule out reversible causes, brain imaging
  
  
• Treatments: Not curable, but symptoms can be managed
  
  

Common Treatments

• Medications: donepezil, rivastigmine, memantine
  
  
• Structured routines & safety measures (locks, reminders)
  
  
• Support for caregivers
  
  

 

 

 

 

 

 

 

 

 

Depression (in older adults)

What is it?

• A mood disorder causing persistent sadness, loss of interest, and changes in energy, sleep, or appetite.
  
  
• Often mistaken for dementia in the elderly (“pseudodementia”).
  
  

Key Signs & Symptoms

• Sadness, hopelessness, withdrawal
  
  
• Low energy, poor concentration
  
  
• Sleep or appetite changes
  
  
• May complain of memory loss (but unlike dementia, attention usually intact once mood improves)
  
  

Safety Considerations

• Risk of self-harm or suicide
  
  
• May neglect self-care (not eating, not taking meds)
  
  
• Needs emotional support, careful assessment
  
  

Tests/Treatments Ordered

• Tests: Screening tools (GDS – Geriatric Depression Scale), labs to rule out other causes
  
  
• Treatments: Therapy, medications, lifestyle support
  
  

Common Treatments

• Antidepressants (SSRIs like sertraline, citalopram)
  
  
• Counseling/therapy
  
  
• Exercise, social engagement
  
  

 

 

 

 

 

 Quick Memory Tip:

• Delirium = sudden, fluctuates, reversible
  
  
• Dementia = slow, progressive, irreversible
  
  
• Depression = mood-based, can mimic dementia, treatable