The elderly often gets confused very easily. Confusion can occur suddenly (acute) or gradually (chronic). Confusional state can be caused by:

  • Direct insult or injury to the brain such as head trauma, cerebrovascular disease, tumour.
  • Indirect causes can be due to physical illness, infection, metabolic disturbances, intoxication, toxic or poisoning.
  • Emotional disorders.
  • Social causes such as moving house.

10 – 40% of elderly admitted to the hospital with acute confusion. About 10% of the elderly living in the community has chronic confusion.

Signs and Symptoms

You may suspect a person to have confusion if you noticed:

  • A person becoming more forgetful or having problems remembering recent events.
  • Having problems in concentration or focusing their attention when doing things, when answering questions and so on.
  • A person starts to develop changes in their behavior such as starting to get more agitated or even becomes more aggressive.
  • A person goes through changes in their mood sometime being very depressed or become happier than normal or a mixture of both at the same time or through other range of emotions.
  • A person may start showing difficulties in doing activities which they are used to doing everyday.

You can look for more details on acute confusional states:

  • As in delirium

You can look for more details on chronic confusional states:

  • As in dementia


  • Risk of injury to self and others
  • Malnourished and dehydration from self neglect
  • Getting lost
  • Loosing your property
  • Family discord


Treatment can be:

  • The caretaker
  • The patient:
    • Non-drug
    • Your doctor may give you drugs to reduce the behavior and emotional problems


  • Practicing Healthy life style i.e. avoid smoking, eating well.
  • Early detection and treatment of medical condition which can lead to acute and chronic confusion.
  • Mental exercise- reading and keeping yourself active mentally.


For chronic confusion

  • Validation therapy
  • Reminiscence therapy and life review
  • Reality orientation

Support Groups

NASCOM (National Council of Senior Citizens Organisations Malaysia)

AFDM(Alzheimer’s Disease Foundation of Malaysia) (

Persatuan Pesara Kerajaan Majlis Pusat Kebajikan Malaysia

Gerantology Association of Malaysia (

Last Reviewed : 20 April 2012
Writer : Dr. Suraya binti Yusoff
  : Dr. Susy Mathew
  : En. Harol Hanam bin Muhammed Wahid
Reviewer : Prof. Madya Dr. Ramli Bin Musa