disorientation

Disorientation is a state in which a person cannot correctly identify time, place, or person. It is a symptom rather than a disease and can be acute, transient, or persistent. Clinically it may present as time disorientation (unclear what day or season it is), place disorientation (being unsure of location), or person disorientation (not recognizing familiar individuals).

Common causes include medical conditions such as hypoglycemia, infections, stroke or head injury, metabolic disturbances, and dehydration. Neurological disorders (dementia, Parkinson’s disease), psychiatric illness, and substance effects or withdrawal can produce disorientation. Medications with sedative or anticholinergic properties, sleep deprivation, and sensory overload in unfamiliar environments are additional contributing factors.

Symptoms vary but often include repetitive questions, misidentification of people, getting lost in familiar surroundings, or appearing dazed or irritable. Disorientation can accompany delirium, which features acute onset and fluctuating symptoms; it also overlaps with dementia in chronic settings.

Evaluation emphasizes safety and identifying reversible causes. Immediate steps include ensuring a safe environment, checking glucose and vital signs, and gathering a history from witnesses. Medical assessment may involve physical and neurological examination, basic laboratory tests, and targeted imaging. Management focuses on treating the underlying cause, correcting metabolic issues, adjusting medications, rehydration, and supporting sleep and orientation.

Prognosis depends on cause and context. Some instances are reversible, especially if treated early, while others reflect chronic illness. Prompt recognition reduces risk of harm and complications, particularly in older adults at risk for delirium.