Mental status changes are one of the most common presentations of electrolyte imbalances. According to "Cecil Medicine," the prevalence of acute cases of mental confusion during hospital stays is approximately 60 percent in elderly patients, with 56 percent of the cases presenting for the first time during the hospitalizations. Many of these cases of confusion are caused by electrolyte imbalances, especially sodium, calcium and potassium.
Sodium and Delirium
Imbalances in sodium can result in delirium, an acute confused state, according to "Harrison's Principles of Internal Medicine." Both high and low blood sodium can result in confusion and mental alterations, especially when connected to natremic cerebral edema or sodium imbalance-induced swelling in the brain. The symptoms associated with this form of confusion include memory loss, deficit of attention, alterations in sleep-wake cycles, hallucinations and delusions.
Calcium and Confusion
According to "Harrison's Principles of Internal Medicine," abnormally high blood levels of calcium can lead to confusion characterized by vague neuropsychiatric symptoms. The mental signs and symptoms of elevated calcium levels include difficulty focusing, trouble maintaining conversations, mood swings, personality changes and problems with following commands.
Potassium Imbalances
Although more commonly associated with muscle weakness and heart conduction problems, potassium imbalances can produce cognitive dysfunctions as well. The signs and symptoms of confusion in potassium imbalances surround motor difficulties and cognitive delay, according to "Harrison's Principles of Internal Medicine." These signs and symptoms include apathy, inability to recite months backward, difficulty with repetitive tasks, disorganized thought processes, lethargy, reduced awareness and altered levels of consciousness.
References
- "Harrison's Principles of Internal Medicine"; Anthony Fauci, M.D., et al. (eds.); 2008
- "Cecil Medicine"; Lee Goldman, M.D. and Dennis Ausiello, M.D.; 2008
- Mayo Clinic: Low Sodium


