Confusion

Confusion is the inability to think as clearly or quickly as you normally do. You may feel disoriented and have difficulty paying attention, remembering, and making decisions.

Considerations

Confusion may come on quickly or slowly over time, depending on the cause. Many times, confusion lasts for a short time and goes away. Other times, it is permanent and not curable. It may be associated with delirium or dementia.

Confusion is more common in older people and often occurs during a hospital stay.

Some confused people may have strange or unusual behavior or may act aggressively.

Causes

Confusion may be caused by different health problems, such as:

Alcohol or drug intoxication

Brain tumor

Head trauma or head injury (concussion)

Fever

Fluid and electrolyte imbalance

Illness in an older person, such as loss of brain function (dementia)

Illness in a person with existing neurological disease, such as a stroke

Infections

Lack of sleep (sleep deprivation)

Low blood sugar

Low levels of oxygen (for example, from chronic lung disorders)

Medicines

Nutritional deficiencies, especially niacin, thiamine, or vitamin B12

Seizures

Sudden drop in body temperature (hypothermia)

Home Care

A good way to find out if someone is confused is to ask the person his or her name, age, and the date. If they are unsure or answer incorrectly, they are confused.

If the person does not usually have confusion, contact a health care provider.

A confused person should not be left alone. For safety, the person may need someone nearby to calm them and protect them from injury. Rarely, physical restraints may be ordered by a health care professional.

To help a confused person:

Always introduce yourself, no matter how well the person once knew you.

Often remind the person of his or her location.

Place a calendar and clock near the person.

Talk about current events and plans for the day.

Try to keep the surroundings calm, quiet, and peaceful.

For sudden confusion due to low blood sugar (for example, from diabetes medicine), the person should drink a sweet drink or eat a sweet snack. If the confusion lasts longer than 10 minutes, contact the provider.

Contact to Doctor

Cold or clammy skin

Dizziness or feeling faint

Fast pulse

Fever

Headache

Slow or rapid breathing

Uncontrolled shivering

Also call 911 or the local emergency number if:

This is the first time someone becomes confused for no reason

Confusion has come on suddenly in someone with diabetes

Confusion came on after a head injury

The person is in danger of harming themselves or others

The person becomes unconscious at any time

If you have been experiencing confusion, contact your provider for an appointment.

What to Expect at Your Office Visit

The doctor will do a physical examination and ask questions about the confusion. The doctor will ask questions to learn if the person knows the date, the time, and where he or she is. Questions about recent and ongoing illness, among other questions, will also be asked.

Tests that may be ordered include:

Blood tests

CT scan of the head

Electroencephalogram (EEG)

Mental status tests

Neuropsychological tests

Urine tests

Treatment depends on the cause of the confusion. For example, if an infection is causing the confusion, treating the infection will likely clear the confusion.

Alternative Names

Disorientation; Thinking - unclear; Thoughts - cloudy; Altered mental status - confusion