The cognitive and behavioral nature of acute confusional states

Two hundred thirty-eight elderly hospitalized medical patients, 47.5% of whom became acutely confused, were studied to address two questions about the cognitive and behavioral nature of the phenomenon, acute confusional states. The first question was: "Is there a pattern of cognitive deficits and psychomotor behaviors that is representative of acute confusion?" Maximum likelihood factor analysis of two measures of acute confusion with varimax rotation resulted in a five-factor solution including both cognitive and behavioral dimensions, dimensions representing a mere 29.8% of the variance. The second question was: "Is there a combination of these cognitive and behavioral features that aids in the diagnosis of an acute confusional state?" Stepwise discriminant function analysis indicated that nine of these cognitive and behavioral features were diagnostic of acute confusion, with 90.34% of the subjects correctly classified on the basis of this equation. Overall, findings indicate that more is known about what an acute confusional state is not than about what it is. Implications for nursing practice and recommendations for further study are offered.