De–Lira: to be displaced from one's furrow. Acute cognitive impairment complicates one in five hospitalisations, like a cognitive superbug penetrating healthcare environments. The kaleidoscopic symptom profile comprises generalised cognitive and neuropsychiatric disturbances. Contrasting hyperactive and hypoactive presentations complicate detection, but clinical variants share core cognitive disruptions – inattention and diminished comprehension that creates the clouded consciousness we call confusion. Half of cases occur in the context of underlying dementia with growing recognition of delirium as an accelerating and possibly causal factor in dementia. Historically understudied, recently established European and American associations can finally bring this Cinderella to the neuroscientific ball.