Alzheimers, Dementia and Delirium

Introduction

The patient who is afflicted with any of these conditions is confused and disoriented and in the case of an acute delirium the condition may be so pronounced that the patient cannot be distinguished from a person with a psychosis. In the following I will describe several of these changed states of cognitive functioning.

The above table provides some clarity and connect via links to any of the topics of interest

Dementia or "Non-Alzheimers Dementias"

Anything, which is not Alzheimers is lumped together as "dementias". They all are leading to a lack of memory and symptoms very similar to Alzheimers. But they are distinct clinical entities and are dealt with separately in the literature. In the following I will only mention the most common ones.

Infectious Causes of Delirium

Many serious infections such as malaria, meningitis, encephalitis and serious pneumonia with high fevers and possible circulating toxins lead to a delirium. Septicemia may be hidden first and a delirium may be the first sign that something serious is going on. In AIDS patients there may be opportunistic infections with other pathogens as mentioned under dementia before.

Structural Causes of Delirium

There are a number of structural lesions that can cause a delirium. Perhaps the most common is a stroke (ischemic or hemorrhagic in origin). Other common lesions are metastases into the brain from a primary tumor located elsewhere in the body (often lung, bone, liver, prostate or breast). Hemorrhages, such as a subarachnoid or subdural, can also cause delirium. A brain abscess, often from dirty needles in the street drug scene, can also suddenly present as a delirium.

Disclaimer

This outline is only a teaching aid to patients and should stimulate you to ask the right questions when seeing your doctor. However, the responsibility of treatmentstays in the hands of your doctor and you.

References

1. OL Lopez et al. Neurology 2000 Dec 55(12):1863-1869.

2. K Yasojima et al. Brain Res 2000 DEC 887(1):80-89.

3. A Kontush et al. FreeRadicBiol Med2001Jan30(1): 119-128.

4. H Vanderstichele et al. Amyloid 2000Dec7(4):245-258.

5. Neely et al. Lipids 2000 Nov35(11):1249-1257.

6. RA Yokel Neurotoxicology 2000 Oct21(5):813-828.

7. Petanceska et al. Exp Gerontol 2000 Dec 35 (9-10):1317-1325.

8. MB Liddell et al. Brit J Psychiatry 2001 Jan 178: 7-11.

9. Sramek et al.ExpertOpinInvestigDrugs2000Apr9(4):899-915.

10.K Kosaka et al. Neuropathology 2000 March 20(1): 1-7.

11.V Haroutunian et al.Arch Neurol 2000 Aug57(8):1145-1150.

13. M Haltia Ann Med 2000 Oct 32(7): 439-500.

Last Modified: Jan. 20, 2007