Confusion overview
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief: Aditya Govindavarjhulla, M.B.B.S. [2]
Overview
Confusion refers to mental dysfunction in which a lack of attention and disorientation occurs with the inability to think with normal speed or clarity. It is the inability to maintain a coherent stream of thought or action.
Pathophysiology
Confusion results from global impairment of function of brain. Few areas of brain are identified for various presentations of confusion. Drugs, poisons, chemicals interact with the neurotransmitters and cause confusion. Inflammatory agents are involved in conditions like fever.
Causes
Confusion is a common symptom associated with various diseases and metabolic disorders. Common causes of confusion include insults to the central nervous system (CNS), metabolic disorders, and the side effect of medications or illicit drugs.
Differentiating Confusion from other Diseases
Various conditions such as dementia, depression and amnesia involve confusion as part of their presentation. Obtaining a clear history about the onset of symptoms, and the onset of confusion in association with other symptoms, helps in differentiating confusion from other conditions.
Epidemiology and Demographics
Nearly about 30% of older patients admitted for medical conditions are confused at some point of time during their admission[1]. In surgical wards the chances of confusion ranges from 10-50%[2]. Increasing rates are seen in patients admitted to intensive care units and in hospice care. There is no significant difference in the distribution based upon gender or race.
Risk factors
Increasing age, admission to the hospital, post-surgical status, alcoholism, and underlying brain lesions are a few important risk factors for confusion. Special care is required for elderly patients who are hospitalized.
Causes
Confusion commonly occurs in various metabolic disorders and disease states. Causes of confusion in the hospital setting commonly include infections and medications. In community, confusion is caused by primary insults to the central nervous system, metabolic conditions, and the effects of medications or drugs.
References
- ↑ Francis J (1992). "Delirium in older patients". J Am Geriatr Soc. 40 (8): 829–38. PMID 1634729. Unknown parameter
|month=ignored (help) - ↑ Dyer CB, Ashton CM, Teasdale TA (1995). "Postoperative delirium. A review of 80 primary data-collection studies". Arch. Intern. Med. 155 (5): 461–5. PMID 7864702. Unknown parameter
|month=ignored (help)