Causes for sudden confusion in elderly?

Answer 1

possible causes of acute confusional state / delirium

- UTI : If seeking advice from a healthcare provider regarding a quick onset of confusion, you might be surprised if the doctor orders a urine specimen. Actually, a urine specimen is not a bad idea since urinary tract infections (UTIs) are a common cause of delirium in the elderly.

- Keep reminding the doctors to check for UTIs, and get them to do blood tests even if the urine tests are clear, because my mom's infections didn't always show up in her urine samples even when she had high uric acid in her blood.

- UTI's are extremely common in the elderly and they do cause confusion. My father recently passed away from complications following a sever UTI that went septic (into his blood stream).

- My 92 year old grandmother suddenly got very confused and when we took her to the hospital she was diagnosed with a severe UTI caused by mild dehydration.

Common Symptoms of UTI in Elders

- Painful urination

- Frequency or more frequent urination

- Incontinence or incontinence that is unusual for that person

- Flank pain

- Fever

- Confusion or delirium

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

- 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)

- thyroid deficiency

Reversible causes of delirium include the following:

- Metabolic problem - highest incident - 20-40% of cases of delirium result from a organ failure (liver, kidney) diabetes, hyperthyroidism, hypothyroidism

- Electrolyte disturbances, especially dehydration, sodium (sodium) imbalance, and thyroid problems

- Infection, especially urinary or respiratory tract infection

- Intracranial, such as a brain infection, hemorrhage, stroke, or tumor (rare)

- Urinary or fecal problems, such as not being able to urinate or have a bowel movement

- Myocardial (heart) and lungs, eg heart attack, problems with heart rhythm, worsening of heart failure or chronic obstructive lung disease

- A head injury/trauma - fall

Tests may include:

Blood tests

CT scan of the head

Electroencephelogram EEG

Mental status tests

Neuropsychological tests

Urine tests

Thyroid function tests

Thyroid stimulating hormone level

vascular dementia

- CT scan of the head showed multiple lacunar infarcts in the right basal ganglia and left cerebellar region.

Delirium can also result from too little stimulation of the senses, especially in people who already have some degree of mental impairment. In one study, delirium after an operation occurred twice as often in patients in intensive care units without windows as in patients in similar units with windows. In addition, a form of delirium that occurs at night (ie, sundowning) may be partly due to sensory deprivation. Vision and hearing loss may make it more difficult for the person to perceive reality and increase the chances of delusions or hallucinations.

The main goal of treatment is to identify and correct the underlying cause of delirium. Generally, a comprehensive medical evaluation is needed, including specific laboratory tests. These may include simple blood tests and more sophisticated tests like brain imaging studies (eg, CAT scan and MRI). Unless they are absolutely necessary, all drugs are generally stopped.

* Most importantly, caregivers can't be too careful when they notice a change in behavior in an older adult, no matter how subtle. "Falls, confusion, new onset of incontinence in someone who had been getting to the bathroom, decrease in appetite," she says, "any of these can be a sign of a urinary tract infection.