Many of these episodes of disorientation are caused by electrolyte abnormalities, particularly those involving sodium, calcium, and potassium levels. According to the classic ‘Harrison’s Principles of Internal Medicine,’ sodium imbalances can result in delirium, which is defined as an acute condition of confusion.
Elevated electrolyte levels can also be caused by dehydration. Medication-induced alterations in mental status in the elderly are a common occurrence. A large number of older persons are taking blood pressure drugs and diuretic medications. Older people who use diuretics may have dizziness and lightheadedness as a result of losing too much fluid.
Disturbances in the electrolyte and fluid balances Disturbances in fluid and electrolyte balance, as well as infections and prescription side effects, are the most common causes of disorientation in elderly hospitalized patients (e23).
Sodium. Low sodium levels, commonly known as hyponatremia, allow water to leak into the cells of the body. High sodium levels, also known as hypernatremia, cause fluid to drain from the cells. In the case of either of these events occurring in brain cells, it might result in changes in personality as well as headaches, disorientation, and tiredness.
Sodium is the most crucial electrolyte for brain health out of all the electrolytes. When salt levels go dangerously low, a number of symptoms manifest themselves, ranging from headaches to weariness to brain damage.
Dehydration, as well as accompanying hypoglycemia and electrolyte imbalance, can result in delirium in certain people. In these instances, therapy may entail the correction of arterial blood gases as well as the levels of blood sugar and electrolytes in order to restore the body’s fluid balance and alleviate symptoms.
The most prevalent electrolyte abnormalities detected in the elderly are hypernatremia and hyponatremia, both of which are linked with a high mortality rate.
Hyponatremia, often known as low sodium, is the most prevalent kind of electrolyte imbalance that is seen.
Gastrointestinal losses or renal excretion can both cause a loss of free water to accumulate (eg, osmotic diuresis or diabetes insipidus). Hypernatremia can result in neurologic symptoms such as altered mental state, weakness, irritability, focal neurologic impairments, and even coma or convulsions if not treated immediately.
Hypokalemia can manifest itself in the neuropsychiatric setting as memory impairment, disorientation, and confusion.
Acute hypocalcemia is characterized by increased neuromuscular excitability and tetany as the primary symptoms. Psychosomatic symptoms such as altered mental state and convulsions are common CNS signs of acute hypocalcemia.
The presence of excessive or insufficient electrolytes such as sodium, potassium, calcium, and magnesium, as well as disorders of acid-base metabolism, can result in neurological effects such as confusion, convulsions, seizures, muscle weakness, tetany (muscle spasm and irritability), and cramps, among other things.
A common sign of delirium or dementia in the elderly is confusion, although it can also occur in patients suffering from serious depression or psychosis. Until a different reason can be determined, the confused patient should be presumed to be suffering from delirium, which is generally curable if the underlying condition is treated properly.
Disturbances in fluid and electrolyte balance, as well as infections and prescription side effects, are the most common causes of disorientation in elderly hospitalized patients (e23). It is well known that delirium is strongly associated with dehydration, which is a multifactorial condition caused, among other things, by the many physiological changes associated with old age (e24).
What Are the Causes of Potassium Deficiency in Elderly People? Malnutrition and dehydration are common problems. Foods high in fat and sugar, as well as a lack of nutrition, can deplete your body’s supply of vitamins and minerals. In addition, a lack of hydration can cause potassium to be lost from the cells.