Downloads: 2 | Views: 81 | Weekly Hits: ⮙2 | Monthly Hits: ⮙2

Case Studies | Medicine | India | Volume 12 Issue 11, November 2023

Cognitive Challenges in Aging: Unmasking Malignancy-Related Altered Mental States in the Elderly

Amit Kumar ^[66] | Rashmi Verma ^[3] | Prachi Singh ^[2]

Abstract: Background: Altered Mental Status (AMS) is common in elderly ED patientswith various potential causes, including structural, metabolic, infections, metastasis, primary central nervous system (CNS) malignancies, polypharmacy and rarely psychiatric causes. Malignancies should be considered as an important, often overlooked cause of AMS in the elderly. Age-related cognitive decline and various neurological presentations make malignancies a significant factor. Case Summary: A 70-year-old farmer arrived with worsening consciousness and decreased urine output. Despite normal initial tests, further investigations uncovered hypernatremia, renal impairment, and unremarkable NCCT head, ultimately unveiling an undisclosed renal malignancy with metastases. This underscores the significance of recognizing paraneoplastic causes when elderly patients with AMS present such symptoms. Conclusion: Altered Mental Status (AMS) in older adults with normal lab results and brain imaging can be misattributed to aging. This case underscores the need for heightened suspicion of occult malignancies, as AMS can precede cancer diagnosis. Vigilance in considering malignancies as a cause can improve outcomes and emphasizes comprehensive care for elderly patients.

Keywords: Altered Mental Status, Elderly, Malignancies, AMS, Paraneoplastic causes

Edition: Volume 12 Issue 11, November 2023,

Pages: 604 - 607