Main Cause of Mental Confusion in the Elderly

Main Cause of Mental Confusion in the Elderly

By Arnaldo Lichtenstein

Whenever I teach clinical medicine to fourth year students of Medicine, I launch the question: - What are the main causes that make grandpa or grandma have confusion?

Some risk: "tumor in the head."

I say "No".

Others bet: "Alzheimer's"

My answer, again: "No."

To every negative reply the class is astonished ... And they get even more astounded when I enumerate the three most common causes:

- Uncontrolled diabetes;

- Urinary tract infection;

- The family spent an entire day shopping, while the elderly person was at home.

It seems like a joke, but it is not. Grandpa and Grandma constantly without feeling thirsty, stop taking liquids.

When there is no one at home to remind them, they dehydrate quickly. Dehydration tends to be severe and affects the whole body. It can cause mental confusion, an abrupt fall of blood pressure, increased heart rate "rapid heart beat", angina (chest pain), coma and even death.

I insist: It is no joke.

In the best age, which begins at 60 years, we have little more than 50% water in the body. This is part of the natural aging process. Therefore, the elderly have lower water reserves.

But there is another complication: even dehydrated, they feel no desire to drink water, because their internal balance mechanisms do not work very well.


Elderly dehydrate easily not only because they have less fluid reserve, but also because they are less likely to perceive a lack of water in their body. Even if the senior is healthy, it degrades the performance of chemical reactions and functions of the entire body.

So here are two caveats:

1 - The first one is for grandmas and grandpas: voluntarily make a habit of drinking liquids. By liquid it is understood we mean water, juices, teas, coconut water and milk. Soup, jelly and fruits rich in water, such as melon, watermelon, pineapple, orange and tangerine also work. The important thing is, every two hours, put some liquid inside. Remember this!

2 - My second warning is for the family: constantly offer liquids for the elderly. Meanwhile, be attentive. Realize if they are rejecting liquids, overnight, they can become confused, irritable, staring out into space and demonstrate a lack of attention to surroundings. It is almost certain that these symptoms are caused by dehydration.

"Get liquids into them and quickly seek medical assistance."

Arnaldo Lichtenstein (46), MD, is a clinician at General Hospital and Clinics and associate professor, Department of Clinical Medicine, Faculty of Medicine, University of São Paulo (USP).

Source: In


Translated from the Portuguese version by:



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Author`s name Oksana Orlovskaya