Dementia/Delirium/Depression; What’s the Difference?

	Depression	Dementia	Delirium
Presenting Symptoms	Depressed mood, negative self-talk, lethargy, appetite and sleep disturbances	Difficulty w/ memory, disorientation to time, place and person; disturbances in intellectual reasoning and thinking	Disorientation, mental confusion, emotional liability, manic-like behavior, hallucinations
Onset	Gradual; may be connected to onset of physical illness, loss of family or friends, changes in financial or living situation	Gradual; progressive loss of intellectual functioning; increasing confusion; loss of ability to perform familiar tasks	Sudden; may occur following illness or surgery; deterioration in functioning progress very quickly
Cognitive features	Loss of cognitive functioning is rare, but elder has difficulty concentrating and making decisions, and may experience minor memory loss	Difficulty remembering recent events, learning new tasks, and communicating. Becomes confused easily about directions and personal location, even in a familiar place	Mental confusion and disorientation that occurs rapidly. Fluctuating levels of awareness with severe difficulties maintaining attention
Emotional Features:	Loss of interest or pleasure in favorite activities; persistent sadness, irritability, guilt and hopelessness. Seems lethargic and apathetic or intensely worried	Passive and withdrawn as the elder loses touch with the immediate environment. May become agitated when confronted about cognitive losses	Agitated, erratic mood swings, anxious, uncooperative. May become aggressive physically and verbally toward others
Physical Features	Appetite, sleep disturbances, vague somatic complaints that do not respond to medical treatment. Looks very sad.	Looks “lost” and confused. May dress inappropriately or show signs or lack of self-care	May have a “wild-eyed” look and appear very disoriented. Physical appearance may be disheveled.
Risk Factors	Family history of depression, female, social isolation, physical illness, low income, taking medications known for side effect of depression	Family history of Alzheimer’s Disease or Down syndrome, advanced age	Taking multiple medications, history of drug/alcohol use, poor nutrition and hydration, recent illnesses or surgery, presence of Parkinson’s disease or MS, or generally poor health.