Confusion mostly refers to impaired consciousness and impaired cognitive function. Possible causes of impaired consciousness and impaired cognitive function after femoral neck fracture replacement surgery in more than eighty old people include postoperative delirium, cerebrovascular disease, Alzheimer’s disease and so on. 1. Postoperative delirium: there is a certain possibility of postoperative delirium after surgical diseases, which may be related to factors such as advanced age, drug reaction, central system lesions, etc. Common manifestations are decreased attention, memory impairment, slurred speech, etc., which are usually more obvious in 3 days after surgery, and basically disappear in 7 days after surgery. 2. Cerebrovascular disease: such as cerebral infarction, because the thrombus enters the cerebral artery with the blood flow, blocking the blood vessel to cause necrosis of brain tissue after ischemia and hypoxia, which can cause sudden consciousness disorders, crooked mouth, hemiparesis and other symptoms. 3. Alzheimer’s disease: also known as dementia, it is a disease of the central nervous system, which can also cause memory loss, incoherence, and depression symptoms. There are many causes of postoperative consciousness disorders and cognitive impairment in the elderly. It is recommended to improve the relevant examinations under the guidance of the doctor to clarify the cause of the disease and carry out targeted treatment.