Confusion, Memory Loss, and Altered Alertness

It is not unusual to occasionally forget where you put your keys or glasses, where you parked your car, or the name of an acquaintance. As you age, it may take you longer to remember things. Not all older adults have memory changes, but they can be a normal part of aging. This type of memory problem is more often annoying than serious.

Memory loss that begins suddenly or that significantly interferes with your ability to function in daily life may mean a more serious problem is present.

• Dementia is a slow decline in memory, problem-solving ability, learning ability, and judgment that may occur over several weeks to several months. Many health conditions can cause dementia or symptoms similar to dementia. In some cases dementia may be reversible. Reference Alzheimer's disease Opens New Window is the most common cause of dementia in people older than age 65.
• Delirium is a sudden change in how well a person's brain is working (mental status). Delirium can cause confusion, change the sleep-wake cycles, and cause unusual behavior. Delirium can have many causes, such as withdrawal from alcohol or drugs or medicines, or the development or worsening of an infection or other health problem.
• Amnesia is memory loss that may be caused by a head injury, a stroke, substance abuse, or a severe emotional event, such as from combat or a motor vehicle accident. Depending upon the cause, Reference amnesia Opens New Window may be either temporary or permanent.

Reference Confusion or decreased alertness may be the first symptom of a serious illness, particularly in older adults. Health problems that cause confusion or decreased alertness can include:

• Infections, such as a Reference urinary tract infection Opens New Window, Reference respiratory infection Opens New Window, or Reference sepsis.
• Alzheimer's disease.
• Reference Asthma Opens New Window or Reference COPD Opens New Window, which cause a decrease in the amount of oxygen or an increase in the amount of carbon dioxide in the blood.
• Cardiac problems, such as Reference heart failure Opens New Window, Reference coronary artery disease Opens New Window, or irregular heartbeats (arrhythmias), that reduce blood flow.
• Problems from Reference diabetes Opens New Window.
• Reference Kidney Opens New Window or Reference liver failure Opens New Window, which causes high levels of toxins to build up in the blood.
• Malnutrition and vitamin deficiencies caused by problems, such as long-term alcoholism (Reference Wernicke-Korsakoff syndrome Opens New Window).
• Mental health problems, such as Reference depression Opens New Window or Reference schizophrenia Opens New Window.
• Thyroid problems, such as Reference hypothyroidism Opens New Window, Reference myxedema coma Opens New Window, or Reference hyperthyroidism Opens New Window.

Alcohol and many prescription and nonprescription Reference medicines can cause confusion or decreased alertness. These problems may develop from:

• Taking too much of a medicine (overmedicating). Overuse of medicines may be the single biggest cause of memory loss or confusion in older adults.
• Alcohol and medicine interactions. This is a problem, especially for older adults, who may take many medicines at the same time.
• Misusing or abusing a medicine or alcohol.
• Drug intoxication or the effects of withdrawal.

Other causes of confusion or decreased alertness can include:

• A head injury.
• Decreased or blocked blood flow to the brain. This may occur during a Reference transient ischemic attack Opens New Window (TIA) or a Reference stroke Opens New Window.
• Infection, such as a brain abscess, Reference encephalitis Opens New Window, Reference meningitis Opens New Window, or sepsis.
• Reference Sexually transmitted infections Opens New Window, such as Reference syphilis Opens New Window (late-stage) and human immunodeficiency virus (Reference HIV Opens New Window).
• A seizure disorder (Reference epilepsy Opens New Window).
• Brain tumors.

Conditions in the environment that can cause changes in the Reference level of consciousness Opens New Window include:

• Cold temperature exposure, leading to Reference hypothermia.
• High temperature exposure, leading to Reference heatstroke Opens New Window.
• Hospitalization. This especially affects older adults when their environment and routines are changed.
• Decreased oxygen in the blood (hypoxia) from high altitude.
• Exposure to toxins (poisons), such as Reference carbon monoxide Opens New Window.

Many times other symptoms are present, such as a fever, chest pain, or the inability to walk or stand. It is important to look for and tell your doctor about other symptoms you experience when confusion or decreased alertness occurs. This can help your doctor determine the cause of your symptoms.

A decrease in alertness may progress to Reference loss of consciousness Opens New Window. A person who loses consciousness is not awake and is not aware of his or her surroundings. Fainting (Reference syncope Opens New Window) is a form of brief unconsciousness. Coma is a deep, prolonged state of unconsciousness.

Reference Check your symptoms to decide if and when you should see a doctor.

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This information does not replace the advice of a doctor. Healthwise, Incorporated disclaims any warranty or liability for your use of this information. Your use of this information means that you agree to the Reference Terms of Use. Reference How this information was developed to help you make better health decisions.