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 

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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