Possible signs of cognitive disorders and delirium include sudden personality changes, impaired thinking, or unusual anxiety or depression.

A patient who suddenly becomes agitated or uncooperative, experiences personality or behavior changes, has impaired thinking, decreased attention span, or intense, unusual anxiety or depression, may be experiencing cognitive disorders or delirium. Patients who develop these symptoms need to be assessed completely.

The symptoms of delirium are similar to symptoms of depression and dementia.

Early symptoms of delirium are similar to symptoms of anxiety, anger, depression, and dementia. Delirium that causes the patient to be very inactive may appear to be depression. Delirium and dementia are difficult to tell apart, since both may cause disorientation and impair memory, thinking, and judgment. Dementia may be caused by a number of medical conditions, including Alzheimer disease. Some differences in the symptoms of delirium and dementia include the following:

• Patients with delirium often go in and out of consciousness. Patients who have dementia usually remain alert.
• Delirium may occur suddenly. Dementia appears gradually and gets worse over time.
• Sleeping and waking problems are more common with delirium than with dementia.

In elderly patients who have cancer, dementia is often present along with delirium, making diagnosis difficult. The diagnosis is more likely dementia if symptoms continue after treatment for delirium is given.

In patients aged 65 or older who have survived cancer for more than 5 years, the risk for cognitive disorders and dementia is increased, apart from the risk for delirium.

Regular screening of the patient and monitoring of the patient's symptoms can help in the diagnosis of delirium.

Glossary Terms

A condition in which a person is unable to relax and be still. The person may be very tense and irritable, and become easily annoyed by small things. He or she may be eager to have an argument, and be unwilling to work with caregivers to make the situation better.

A brain disorder that usually starts in late middle age or old age and gets worse over time. Symptoms include loss of memory, confusion, difficulty thinking, and changes in language, behavior, and personality. Also called Alzheimer dementia.

Feelings of fear, dread, and uneasiness that may occur as a reaction to stress. A person with anxiety may sweat, feel restless and tense, and have a rapid heart beat. Extreme anxiety that happens often over time may be a sign of an anxiety disorder.

A term for diseases in which abnormal cells divide without control and can invade nearby tissues. Cancer cells can also spread to other parts of the body through the blood and lymph systems. There are several main types of cancer. Carcinoma is a cancer that begins in the skin or in tissues that line or cover internal organs. Sarcoma is a cancer that begins in bone, cartilage, fat, muscle, blood vessels, or other connective or supportive tissue. Leukemia is a cancer that starts in blood-forming tissue such as the bone marrow, and causes large numbers of abnormal blood cells to be produced and enter the blood. Lymphoma and multiple myeloma are cancers that begin in the cells of the immune system. Central nervous system cancers are cancers that begin in the tissues of the brain and spinal cord. Also called malignancy.

The mental process of thinking, learning, remembering, being aware of surroundings, and using judgment.

A mental state in which a person is confused, disoriented, and not able to think or remember clearly. The person may also be agitated and have hallucinations, and extreme excitement.

A condition in which a person loses the ability to think, remember, learn, make decisions, and solve problems. Symptoms may also include personality changes and emotional problems. There are many causes of dementia, including Alzheimer disease, brain cancer, and brain injury. Dementia usually gets worse over time.

A mental condition marked by ongoing feelings of sadness, despair, loss of energy, and difficulty dealing with normal daily life. Other symptoms of depression include feelings of worthlessness and hopelessness, loss of pleasure in activities, changes in eating or sleeping habits, and thoughts of death or suicide. Depression can affect anyone, and can be successfully treated. Depression affects 15-25% of cancer patients.

The process of identifying a disease, such as cancer, from its signs and symptoms.

In medicine, a disturbance of normal functioning of the mind or body. Disorders may be caused by genetic factors, disease, or trauma.

A mental state marked by confusion about time, place, or who one is.

A loss of part or all of a physical or mental ability, such as the ability to see, walk, or learn.

In medicine, to regularly watch and check a person or condition to see if there is any change. Also refers to a device that records and/or displays patient data, such as for an electrocardiogram (EKG).

Checking for disease when there are no symptoms. Since screening may find diseases at an early stage, there may be a better chance of curing the disease. Examples of cancer screening tests are the mammogram (breast), colonoscopy (colon), Pap smear (cervix), and PSA blood level and digital rectal exam (prostate). Screening can also include checking for a person’s risk of developing an inherited disease by doing a genetic test.

An indication that a person has a condition or disease. Some examples of symptoms are headache, fever, fatigue, nausea, vomiting, and pain.