Acute confusional state in the elderly in the tropics are often linked mainly to dehydration. Micronutrient deficiencies and electrolyte derangements are now common features that must be assessed.
My 93 year old mother-in-law was delurius and after a full course of anti-malaria, her amnesia of recent events worsened and her chemistry revealed hyponatremia and re-hyrdation with dietary supplements was instituted and in 48 hours, the amnesia improved drastically but we have no facilities to check the micronutrients because her fluid and semisolid diets are challenging beause of her dentures.