Obstetrics and Gynecology Board Review Pearls of Wisdom

••• Chapter 42^ Ethics, Psychosocial, and Psychiatric Pearls^425

❍ What is dementia?
Disturbed cognitive function that results in impaired memory, personality, judgment, or language.

❍ What is delirium?
“Clouding of consciousness” that results in disorientation, decreased alertness, and impaired cognitive function.

Table 42.2 Delirium Versus Dementia

Delirium Dementia

Causes Infection, substance use/

withdrawal, metabolic and

endocrine disturbances, hypoxia,

toxins, and heavy metals

Most often due to

neurodegenerative diseases

(Alzheimer, Parkinson,

Huntington, Creutzfeldt–Jakob

diseases, etc),

Onset Acute Gradual

Course Fluctuating from hour to hour Progressive deterioration

level of attention Impaired Intact

Hallucinations Often present Present in only about 30% of

patients with advanced disease

Prognosis Reversible Most often irreversible

However, up to 15% of cases can

be attributed to treatable cause,

and thus can be reversed.

❍ What is the most common cause of dementia?
Alzheimer disease—it accounts for 70% to 80% of all dementia cases.

❍ What are some examples of treatable causes of dementia?
Uremia, syphilis, depression, hypothyroidism, and vitamin B12 deficiency.

❍ What conditions may mimic dementia in the elderly?
Hypothyroidism
Depression – referred to as pseudodementia