Symptoms of delirium usually begin over a few hours or a few days. They typically occur with a medical problem. Symptoms often come and go during the day. There may be periods of no symptoms. Symptoms tend to be worse at night when it's dark and things look less familiar. They also tend to be worse in settings that aren't familiar, such as in a hospital. Primary symptoms include the following. Reduced awareness of surroundings This may result in:  Trouble focusing on a topic or changing topics Getting stuck on an idea rather than responding to questions Being easily distracted Being withdrawn, with little or no activity or little response to surroundings  Poor thinking skills This may appear as:  Poor memory, such as forgetting recent events Not knowing where they are or who they are Trouble with speech or recalling words Rambling or nonsense speech Trouble understanding speech Trouble reading or writing  Behavior and emotional changes These may include:  Anxiety, fear or distrust of others Depression A short temper or anger A sense of feeling elated Lack of interest and emotion Quick changes in mood Personality changes Seeing things that others don't see Being restless, anxious or combative Calling out, moaning or making other sounds Being quiet and withdrawn — especially in older adults Slowed movement or being sluggish Changes in sleep habits A switched night-day sleep-wake cycle  Types of delirium Experts have identified three types:  Hyperactive delirium. This may be the easiest type to recognize. People with this type may be restless and pace the room. They also may be anxious, have rapid mood swings or see things that aren't there. People with this type often resist care. Hypoactive delirium. People with this type may be inactive or have reduced activity. They tend to be sluggish or drowsy. They might seem to be in a daze. They don't interact with family or others. Mixed delirium. Symptoms involve both types of delirium. The person may quickly switch back and forth from being restless and sluggish.  Delirium and dementia Delirium and dementia may be hard to tell apart, and a person may have both. Someone with dementia has a gradual decline of memory and other thinking skills due to damage or loss of brain cells. The most common cause of dementia is Alzheimer's disease, which comes on slowly over months or years. Delirium often occurs in people with dementia. However, episodes of delirium don't always mean a person has dementia. Tests for dementia shouldn't be done during a delirium episode because the results could be misleading. Some differences between the symptoms of delirium and dementia include:  Onset. The onset of delirium occurs within a short time — within a day or two. Dementia usually begins with minor symptoms that get worse over time. Attention. The ability to stay focused or maintain focus is impaired with delirium. A person in the early stages of dementia remains generally alert. Someone with dementia often isn't sluggish or agitated. Rapid changes in symptoms. Delirium symptoms can come and go several times during the day. While people with dementia have better and worse times of day, their memory and thinking skills typically stay at a constant level. 
symptoms delirium begin hours days  typically occur medical problem  symptoms come day  may periods symptoms  symptoms tend worse night it's dark look familiar  tend worse settings aren't familiar  hospital  primary symptoms include following  reduced awareness surroundings may result in:  trouble focusing topic changing topics stuck idea responding questions being easily distracted being withdrawn  little activity little response surroundings  poor thinking skills may as:  poor memory  forgetting recent events knowing who trouble speech recalling words rambling nonsense speech trouble understanding speech trouble reading writing  behavior emotional changes may include:  anxiety  fear distrust depression short temper anger sense feeling elated lack interest emotion quick changes mood personality changes seeing don't see being restless  anxious combative calling out  moaning making sounds being quiet withdrawn — especially older adults slowed movement being sluggish changes sleep habits switched night-day sleep-wake cycle  types delirium experts identified types:  hyperactive delirium  may easiest type recognize  people type may restless pace room  may anxious  rapid mood swings see aren't there  people type resist care  hypoactive delirium  people type may inactive reduced activity  tend sluggish drowsy  daze  don't interact family others  mixed delirium  symptoms involve types delirium  person may quickly switch back forth being restless sluggish   delirium dementia delirium dementia may hard tell apart  person may both  dementia gradual decline memory thinking skills due damage loss brain cells  common cause dementia alzheimer's disease  comes slowly months years  delirium occurs people dementia  however  episodes delirium don't mean person dementia  tests dementia shouldn't delirium episode results misleading  differences symptoms delirium dementia include:  onset  onset delirium occurs short time — day two  dementia begins minor symptoms worse time  attention  ability stay focused maintain focus impaired delirium  person early stages dementia remains generally alert  dementia isn't sluggish agitated  rapid changes symptoms  delirium symptoms can come times day  people dementia worse times day  memory thinking skills typically stay constant level
delirium