Common Causes of Altered Mental Status in Elderly patients

 The most common causes of altered mental status in elderly patients include:

1. Infections: Urinary tract infections, pneumonia, and sepsis are frequent culprits[1][2][3]. Even COVID-19 can cause altered mental status in older adults[5].

2. Metabolic disturbances: Electrolyte imbalances, dehydration, and organ dysfunction (e.g., hepatic encephalopathy) can lead to mental status changes[2][3][6].

3. Medications and drugs: Polypharmacy, drug interactions, overdose, or withdrawal from substances like benzodiazepines and opioids can cause altered mental status[1][2][3].

4. Neurological conditions: Stroke, brain hemorrhage, brain tumors, and seizures can affect mental status[2][3][5].

5. Delirium: This is a common presentation of altered mental status in the elderly, occurring in 7%-10% of geriatric patients in the emergency department[8]. It can be caused by various underlying factors, including those mentioned above.

6. Chronic conditions: Dementia, Parkinson's disease, and other neurodegenerative disorders can contribute to altered mental status[1][5].

7. Toxin exposure: Exposure to substances like carbon monoxide or cyanide can affect mental status[5].

8. Metabolic disorders: Thyroid imbalances and vitamin deficiencies can lead to altered mental function[3].

It's important to note that in elderly patients, the cause of altered mental status is often multifactorial, with several contributing factors present simultaneously[1][2].

Citations:

[1] https://pmc.ncbi.nlm.nih.gov/articles/PMC3614410/

[2] https://www.aafp.org/pubs/afp/issues/2021/1100/p461.html

[3] https://www.webmd.com/mental-health/what-is-altered-mental-status

[4] https://hign.org/consultgeri/resources/symptoms/abrupt-change-mental-status

[5] https://www.mayoclinic.org/diseases-conditions/delirium/symptoms-causes/syc-20371386

[6] https://my.clevelandclinic.org/health/diseases/23159-altered-mental-status-ams

[7] https://www.hmpgloballearningnetwork.com/site/emsworld/article/10850982/acute-altered-mental-status-elderly-patients

[8] https://reference.medscape.com/slideshow/altered-mental-status-elderly-6010546