Clinico-etiological profile of the elderly population with altered mental status in a teaching hospital

This study aimed at evaluating the clinico-etiological profile of altered mental status (AMS) among elderly patients and making recommendations regarding management based on etiologies, thereby improving both morbidity and mortality outcomes.

This retrospective observational study was conducted in a teaching cum tertiary care hospital. Two years data (from July 2017 to June 2019) were extracted from the medical records section, and 172 eligible participants were analyzed using descriptive statistics for clinical outcomes, demographic profiles, and various etiological factors.

A total of 1784 elderly inpatients (age >60 years) were screened from the records, and 172 eligible elderly AMS patients were found eligible for the study. The male elderly population consisted of 110 (63.95%), and the female elderly was 62 (36.04%). The mean age of the study population was 67.82 years. The etiological factors of AMS in the study population were neurological - 47.09% (n = 81), infection - 30.23% (n = 52), metabolic/endocrine - 16.27% (n = 28), pulmonary - 2.32% (n = 4), fall - 1.74% (n = 3), toxic cause - 1.16% (n = 2), and psychiatric illness - 1.16% (n = 2). The total mortality rate was 9.30% (n = 16).

The main etiological factors of AMS in the elderly population were predominantly of neurological, septic, and metabolic causes. These factors were preventable and treatable by training physicians, staff (as most of the physicians in the developing countries are not trained in managing this fragile group of population with multiple comorbidities), and by decentralizing geriatrics health-care setups.