In this episode of Your Aged Care Compass, Coral is joined by psychiatrist Dr Kailas Roberts to discuss three often-confused conditions that affect older adults: dementia, delirium and depression. These conditions can present with overlapping symptoms, such as memory loss, confusion, and mood changes, but their causes, trajectories, and treatments differ significantly. Understanding these nuances is critical for families, carers, and professionals supporting older people through health transitions.
Dr Roberts brings decades of clinical experience and a deep commitment to brain health to this conversation. He explains how each condition manifests, how they can coexist, and why accurate diagnosis is essential, especially when symptoms fluctuate or appear suddenly. Coral also shares personal reflections from her father's experiences with delirium during hospital stays, adding warmth and real-world context to the discussion.
In this episode:
- Dementia is a clinical syndrome caused by various diseases, including Alzheimer’s, vascular dementia, and Lewy body dementia
- Delirium is an acute confusional state that can be reversed if the underlying cause is treated
- Depression is a mood disorder that can mimic dementia symptoms, especially in older adults
- Cognitive symptoms such as memory loss and attention difficulties can appear in all three conditions
- “Depressive pseudodementia” refers to cognitive impairment caused by depression rather than neurodegeneration
- Sudden changes in cognition or behaviour often point to delirium rather than dementia
- Delirium symptoms fluctuate throughout the day, while dementia tends to be more stable
- Depression symptoms may be worse in the morning, unlike dementia, which often worsens later in the day
- A thorough history of the patient is essential to distinguish between these conditions
- Medication changes, infections, and electrolyte imbalances are common triggers for delirium
- Hypoactive delirium, marked by withdrawal and quietness, is often missed but just as serious as hyperactive forms
- Non-drug interventions like reorientation cues and good lighting are key to managing delirium
- Antidepressants can be helpful in depression but should be considered alongside lifestyle and psychological therapies
- Carers are often the first to notice changes. Trusting and acting on their observations can lead to earlier diagnosis and better outcomes.
Resources mentioned:
- Book – Mind Your Brain; The Essential Australian Guide to Dementia
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