Step 1: Compare the time course. Dementia is a slow erosion of memory and intellect unfolding across months or years. Delirium, the acute confusional state, erupts over days to weeks.
Step 2: Pick the unique feature. Because the symptoms in both overlap, the discriminating element must be the tempo of onset. A sudden, acute shift away from a person's usual mental state signals delirium, often superimposed on existing dementia, with inattention as its core sign.
Step 3: Rule out shared features. Confusion, trouble communicating and hallucinations appear in either disorder and therefore cannot separate them. The abrupt change is what is specific.
Onset speed, not the symptom list, is the deciding factor.\[\boxed{\text{Sudden change}}\]