According to the National Center of Continuing Education, Inc.’s online article entitled “Confusion in the Elderly,” acute confusion affects 10% to 40% of seniors who reside in long term care facilities, or nursing homes, and senior patients in the hospitals. Many seniors are also affected by confusion at home. Learn how to recognize delirium and common causes for sudden confusion in seniors.
What is Acute Confusion?
Acute confusion, also known as sudden confusion, secondary dementia, or delirium, begins quickly and often has a cause that can be identified. Correcting all causes of the confusion may result in the return of the person’s normal mental state. Any new confusion in someone of any age should be considered delirium until all possible causes have been ruled out.
Delirium differs from dementia, or chronic confusion, in which the person experiences long-term confusion that tends to get progressively worse and may be associated with degenerative changes in the brain. The most common type of dementia is Alzheimer’s Disease; however, people who have dementia can also experience delirium in addition to the chronic confusion.
What are Signs of Reversible Confusion in Older Adults?
Sudden confusion may be quite obvious and easy to recognize, but a senior can be confused and caregivers may not be aware of the confused state. For example, a family member may be with an elder for hours or days at a time and may recognize that the person is confused, but a caregiver who has limited contact with the person may or may not recognize the confusion. Seniors might be experiencing symptoms of dementia, such as hallucinations, but even those who are with them the majority of the time might not be aware of this unless the person speaks of the vision or tries to touch something that is not visible, for example.
According to the above cited article, “Confusion in the Elderly,” seniors who are experiencing delirium might have the following symptoms:
- short attention span
- sleep disturbances
- speech changes
- hallucinations
- change in state of mind from the person’s baseline
- altered ability to make decisions
These symptoms may or may not indicate that the person is experiencing delirium. For example, sleep disturbances might be the result of multiple interruptions at night, or a short attention span might be due to ADHD. Cultural norms may also play a role in determining what is normal or abnormal behavior as well. Other symptoms may indicate sudden confusion as well.
What are the Causes of Delirium in Seniors?
Sudden confusion in the elderly may be caused by a wide variety of conditions, such as:
- nutritional causes, including dehydration, altered electrolytes such as magnesium and potassium, or low levels of nutrients such as niacin, vitamin B12, vitamin C, or thiamine
- illness or infections, including urinary tract infections and influenza – this may be the only sign that a senior has rather than typical symptoms
- changes in the environment, such as moving to a new home
- medications, including interactions, improper dosing, or side effects
- low blood sugar, especially in seniors with diabetes but may occur in others
- low oxygen levels, including low oxygen levels caused by sleep apnea
- heart conditions and changes in blood vessels and blood circulation
- changes in the way the body regulates body temperature, hypothermia, or hyperthermia
- mini stroke or transient ischemic attack (TIA)
- seizures
- head Injury
- depression
- alcohol or recreational drugs
Alterations in the senses, such as hearing impairment or sight impairment, might be mistaken for confusion. The person may have normal thinking processes but be responding in unusual ways in order to compensate for the lack of ability to hear or see well. Language barriers may also result in a person being inappropriately labeled as confused. For example, someone may speak another language or may be unable to speak and others around them may assume that the person is confused.
Recognize Sudden Confusion in Seniors and Seek Medical Assistance
Confusion is not a normal change of aging. An older person who suddenly becomes confused often has a reversible cause. Recognizing sudden changes in mental status and acting quickly by notifying a healthcare provider can make a big difference in how effective treatment will be. Immediately informing the doctor of the confusion and any other symptoms or changes in routine may greatly help determine the cause of the change in behavior. With prompt treatment of underlying causes, many seniors return to their normal mental state.
This article is for informational purposes only and should not be considered medical advice.
Sources:
National Institutes of Health 2/13/2008 article “Confusion” updated by Luc Jasmin, MD, PhD
North Carolina Nurse Aide I Curriculum approved for 2010
Katrena Wells - Katrena Wells is a RN in NC with 17 1/2 years of experience in oncology, an educator since 1995, and has taught exercise classes since ...
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