Dear Doctors: Why do the elderly lose ground mentally when they go to the hospital? Our grandmother had emergency gall bladder surgery, and afterward she got so confused that she thought our grandfather, who passed away, was in the next room. It lasted for a few days, and it was scary.

Dear Reader: Although we can’t know the exact nature of your grandmother’s cognitive lapse, the type of confusion you describe isn’t unusual in older adults who have been hospitalized. Sometimes referred to as hospital-acquired delirium, it’s a temporary but severe form of mental impairment that affects up to one-third of patients over the age of 70, particularly those undergoing surgery or those in intensive care. The condition is marked by periods of confused thinking, jumbled memory, difficulty understanding speech, agitation, disorientation and even hallucinations.

These episodes of delirium are often interspersed with interludes during which the person is once again lucid. The duration of hospital-acquired delirium can be as brief as a few hours or, as with your grandmother, can continue for several days. In some cases, these fluctuations in awareness can last much longer. In addition to being upsetting to family members, the condition can hinder the patient’s recovery and lead to a general decline in health.

When you consider the many shocks involved with surgery and hospitalization, it’s not surprising that the experience can take a steep mental toll on older adults. Not only has the body endured the physical trauma of a surgical procedure, but the patient is also dealing with the effects of anesthesia and the drugs used to manage pain. Once the patient awakens, the hallmarks of their everyday lives have suddenly vanished. They find themselves isolated in a strange place, being cared for by an ever-changing array of strangers. The bright lights, constant noise, ongoing medical interventions and frequent interruptions of hospital life create a stressful environment. Adding to the burden are factors such as infection, dehydration, poor nutrition, anxiety, poor sleep and the potential side effects of multiple medications.

Treatment begins with basic care. That means making sure the person is hydrated, is getting enough nutrients and adequate sleep, and is warm, dry and comfortable. It’s also important to help them become oriented to their surroundings. This may sound obvious, but it includes making sure that they have and use personal items such as their eyeglasses, hearing aids or dentures. Each of these help to engage their senses, which lets them stay aware of the world around them.

Other things that have proven helpful are daily exercise, exposure to natural light, removing medications that are not absolutely essential and surrounding the person with familiar objects from their home life. A favorite sweater, a stuffed animal or an array of family photographs can provide visual and sensory cues. Music, which boosts brain activity, has been shown to relieve stress and anxiety.

And if the hospital allows visitors, try to go to spend time with your loved one. Patients feel vulnerable and alone in a hospital setting, and having a familiar and loving presence nearby offers great comfort.

(Send your questions to askthedoctors@mednet.ucla.edu. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: Our family spends a lot of time these days on our screens. I’ve always had trouble sleeping (mom brain), but now my husband and our two teen boys are struggling, too. Do you think all the screen time could be why?

Dear Reader: We’re all dealing with so much right now -- stress, anxiety, isolation and uncertainty -- that poor sleep has evolved into an epidemic of its own. And with a large portion of our daily lives taking place online, it’s quite possible that the high-energy light emitted by our computers, tablets and smartphones is adding to the toll.

For many of us, the work day, the school day and even socializing have shifted online. Add to that the hours we were already spending on our screens before the pandemic, and many of us are getting the highest daily doses yet of what’s known as “blue light.”

Similar to sunlight, blue light has been shown to suppress the release of melatonin, a hormone produced by the pineal gland in the brain that makes you feel sleepy. Recent studies have found that prolonged exposure to blue light, particularly in the hours before bed, confuses the brain. Instead of the warm tones of evening light, which signal the brain to power down and prepare for sleep, the blue light emitted by electronic devices insists it’s daytime.

This affects not only the ability to fall asleep, but also to stay asleep and spend adequate time in the various stages of sleep -- especially the all-important deep sleep. That’s a serious problem, because lack of high-quality sleep not only leaves us tired in the short term, it also is associated, over time, with more serious health issues. These include headaches, weight gain, diabetes, high blood pressure, coronary heart disease and depression.

The good news is that you can take specific steps to mitigate the effects of exposure to blue light and improve your ability to fall asleep and stay asleep. One cornerstone of good sleep hygiene is a consistent bedtime. Decide on what your bedtime will be, then end all screen use at least two hours -- and preferably three hours -- before then. If you don’t build in that no-screen buffer, the blue light will continue to tell your brain that it’s broad daylight. This, in turn, confuses your inner clock, which throws off your ability to fall asleep.

In that same vein, block the various digital lights that can populate the bedroom, such as clock dials, smoke alarms and other electronic devices. When it comes to working with a computer or tablet, consider purchasing special filters, which reduce the amount of blue light that a device emits. Protective eyewear that blocks blue light is also available.

Quite a few manufacturers now include a special “night mode” option for smartphones, computers and tablets. When activated, night mode shifts the light emitted by the screen from the high-energy blue light to the warmer end of the spectrum. This all takes planning and discipline, but, considering the stakes, it’s worth it.

(Send your questions to askthedoctors@mednet.ucla.edu. Owing to the volume of mail, personal replies cannot be provided.)

Dear Doctors: I’ve been working from home for six months, so no more bike commutes and no office staircases. My two young kids are home, too, which means I can’t do a lunchtime bike ride, or even go during a break. How bad is it that I’m sitting way more than ever?

Dear Reader: We wish we had better news, but, yes, prolonged sitting is bad for your health. The long stretches of sitting required by so many modern jobs are putting people at risk of a number of adverse health effects. This includes weight gain, obesity, increases in abdominal fat, high blood pressure and Type 2 diabetes. Taken together, these factors are associated with an increase in the risk of cardiovascular disease and cancer, as well as early death. Add in the mental health side effects of prolonged inactivity, such as depression and anxiety, and it’s easy to see how the term “sitting disease” came about.

It wasn't all that long ago -- historians point to the Industrial Revolution -- that we humans began to sit down for extended periods. Prior to that, staying fed, clothed, housed, protected and entertained kept us moving. With more than 600 muscles in our bodies, it’s what we’re literally built to do. This includes walking, running, reaching, climbing, stretching, swimming, twisting, crawling, jumping, bending and lifting throughout long and mostly active days. And while disease, hunger and hardship took their toll in the agrarian world, it does seem that with increasingly sedentary work and play, we’ve now traded one set of health problems for another.

Today, only two out of every 10 workers have active jobs, a decrease of about 80% since 1950. Between desk work, passive transportation and the increasingly sedentary nature of entertainment and play, many people stay seated for at least 10 hours each day. That’s the number research associates with a marked increase in cardiac risk.

All of which means that, even during the pandemic that’s robbed us of our normal lives, we need to get creative and get moving. Fortunately, it doesn’t take much. A study that tracked the mortality rate of 8,000 adults aged 45 and older for four years found that trading 30 seated minutes for the same amount of moderate or vigorous activity lowered the risk of early death by 35%. This joins previous research that pegged duration of sitting -- an hour or more at a stretch -- as a risk factor. People who sat for 30 minutes or less at a time had the best outcomes.

So do your heart, lungs and metabolism a favor and work regular movement into your day. Set a timer to walk a few minutes every half-hour. Get some hand weights and lift throughout the day. Get your kids involved, too: Run and jump and stretch, chase each other around the house, have parades, enjoy moments of planned chaos, take walks together, do yoga, practice deep breathing, ride bikes. Make it a goal to work movement into your family’s daily life, and your body and your kids (and your family doctor) will thank you.

(Send your questions to askthedoctors@mednet.ucla.edu. Owing to the volume of mail, personal replies cannot be provided.)