Confusion

What is confusion?

Confusion is a change in memory, attention, or awareness. Confusion includes puzzling or odd behavior or responses. A confused person may not be aware of what is going on around them. They may not know where they are or what time it is. They may see or hear things that are not there. They may have trouble remembering things. Confused people may find it hard to speak or understand what others say. Their attention wanders and they are easily distracted. They cannot think clearly and have trouble making decisions.

Often, confusion is normal. For example, someone who gets 2 different stories about an upcoming meeting can be confused by conflicting information. This is not a medical problem. Delirium is the word used for confusion caused by a medical problem.

How does it occur?

Confusion that happens as a sudden change is called acute confusion. Confusion may also come on gradually over time. Confusion of either type is often a sign of another problem.

Many things can cause confusion.

• It can come from a head injury, or from a tumor or disease in the brain.
• Dementia can cause confusion about present-day information.
• Changes in the body's oxygen or blood chemistry can cause confusion.
• Serious infections with high fever can cause confusion.
• Sometimes new medicines cause problems.
• Very low blood sugar usually causes confusion.
• Drugs or alcohol can cause confusion if you use too much of them. Confusion can also occur if you have been drinking a lot of alcohol or using drugs and then abruptly stop.
• Even stress, too little sleep, some herbal remedies, or a lack of certain vitamins can cause symptoms, especially in older adults.

What are the symptoms?

Signs and symptoms of confusion can include:

• being unable to concentrate, pay attention, or remember
• drowsiness
• not knowing who you are, where you are, or what day or year it is
• misunderstanding what you see or hear
• being restless or agitated.

How are the causes of confusion diagnosed?

Family members or friends may need to describe the symptoms and when they started. The healthcare provider will do a physical exam and ask about the medical history. The provider will check for possible causes of the symptoms, such as a medical problem. The provider may also ask the person some questions to test memory and thinking and to check for depression.

The following tests may be done:

• blood tests
• CT scan or an MRI
• EEG, or electroencephalogram, to check for problems in the brain
• EKG, or electrocardiogram, to check for heart problems
• urine tests
• X-rays.

How is it treated?

Treatment depends on what caused the confusion. For example, changing medicines, treating a medical problem, or reducing stress may take care of confusion.

Call for medical help when confusion starts suddenly and does not go away. New confusion needs to be checked out right away.

Never leave a confused person alone.