Confusion

What is it?

Confusion refers to a spectrum from mild disorientation (uncertain of date or place) to acute delirium — a severe neuropsychiatric syndrome of fluctuating attention and awareness. Acute confusion in an older adult is a medical emergency until proven otherwise; it is rarely normal aging. Common reversible causes remembered by the mnemonic AEIOU-TIPS include: alcohol, epilepsy, infection (UTI, pneumonia, sepsis), overdose/opioids, uremia, trauma, insulin (hypoglycemia), psychiatric, and stroke. Delirium occurs in up to 30% of hospitalized older adults and doubles mortality when unrecognized.

Common causes

When to see a doctor

• 1Any acute confusion in an older adult — always seek medical evaluation
• 2Confusion with fever — possible CNS infection (meningitis)
• 3Sudden-onset severe confusion or inability to speak (stroke symptoms) — call 911
• 4Confusion after a head injury
• 5Confusion with fluctuating levels of consciousness throughout the day (delirium)

What you can do

• ✓Confusion is a symptom requiring professional evaluation — do not attempt to manage at home without medical guidance
• ✓For a confused loved one, keep the environment calm, well-lit, and familiar
• ✓Gently reorient the person to time, place, and person with a reassuring tone
• ✓Ensure hydration — dehydration is a surprisingly common cause of confusion in older adults

Conditions that cause this symptom

Medications that may help

Treatment depends on the underlying cause. Always consult your provider before starting any medication.

Frequently asked questions