46. DELIRIUM DEMENTIA Onset Acute, often at night Insidious Course Fluctuating , with lucid intervals, during day: worse at night Stable over course of the day Duration Hours to week Months to years
47. Awareness Reduced Clear Alertness Abnormally LOW or HIGH Usually Normal Attention Lacks direction and selectivity; distractibility; fluctuates over course of the day Relatively unaffected Orientation Usually impaired for time; tendency to mistake unfamiliar to familiar place and persons Often impaired
48. Memory Immediate and recent memory impairments Recent and remote memory impairments – the most prominent symptom Thinking Disorganized Impoverished Perception Illusions and Hallucinations (usually visual) Often absent Sometimes: Hallucinations Delusions Illusions
49. Speech Incoherent, hesitant, slow or rapid Difficulty finding words Sleep wake cycle Always disrupted Fragmented sleep Physical Illness or Drug toxicity Either or both present Often absent, especially in Alzheimer’s type
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