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Urinary Tract Infections Mimic Dementia in Seniors

It can be very concerning when an otherwise cognitively healthy senior suddenly, over a matter of days, begins to show rapidly declining mental health symptoms. Memory loss, disorientation, agitation, and even hallucinations raise major red flags for caregivers but many times the cause is simpler than you may think. While these symptoms otherwise warrant an in-depth medical evaluation, a simple urine test could reveal the real culprit; a urinary tract infection.

What Is a Urinary Tract Infection?

Urinary Tract Infections (UTI), also called a bladder infection, are one of the most common infections in elderly people and are the most common infection in residents of long-term care facilities.

The urinary tract includes the kidneys, ureters, bladder and urethra (the kidneys remove extra liquid and waste from the blood in the form of urine, the ureters carry the urine from the kidneys to the bladder, and the bladder stores the urine until it is emptied through the urethra) all working together to rid the body of urine. A UTI occurs when bacteria clings to the opening of the ureter and begins to multiply and spread. Women are more likely to get UTIs than men because their urethras are shorter than men’s.

Older adults are more susceptible to UTI’s. The physical changes in aging individuals such as deteriorating bladder muscles, hormone changes, enlarged prostates, incontinence, presence of a urinary catheter and diabetes contribute to UTI occurrences as well as limited mobility resulting in poor hygiene practices.

Urinary Tract Infection Symptoms

For younger people a UTI typically comes with very clear-cut physical symptoms that logically coordinate to the urinary tract:

  • a more urgent need to urinate
  • increased frequency of urination
  • burning, pain, or discomfort when urinating
  • feeling pressure in the lower abdomen or pelvis, the bladder not feeling empty after urination
  • cloudy, thick, or odorous urine and/or blood in the urine

If left untreated, a person may experience:

  • fever
  • pain in the lower abdomen, flank, or back
  • fatigue
  • nausea, vomiting

These symptoms may appear to be signs of normal aging, but for seniors, these physical symptoms are minimalized or overshadowed by a quick onslaught of behavioral changes which may mimic that of serious cognitive issues such as Alzheimer’s and dementia. Further, UTI symptoms tend to be more severe in seniors who already have deteriorating cognitive illness.

Caregivers should take notice of the following UTI related signs and symptoms in seniors, especially if they develop quickly, often in a matter of just two to three days:

  • Sudden change in behavior or inability to perform tasks that were easily done days before
  • Agitation, restlessness, anger or other emotional inconsistencies
  • Confusion, not knowing what day it is, mixing up names and people and general brain fog
  • Social withdrawal
  • Memory loss and hallucinations ranging from mild to severe
  • Incontinence and inability to recognize the need to urinate or urinary retention
  • Decreased appetite

When Does a Caregiver Need To Take Action?

Some seniors may be embarrassed to discuss these symptoms, so any changes in physical or mental status, especially those that come on rapidly, is a warning sign for caregivers to contact a doctor. Quality caregivers can help by keeping clients clean and dry. Noting the symptoms mentioned above and the sudden onset can help minimize the diagnoses time and avoid costly and timely mental health testing. A UTI is quickly identified with a urine test and usually cured with antibiotics. Left untreated, a UTI can spread throughout the body causing serious problems and even death.

While it seems odd that an infection in the bladder can cause a person memory loss and even hallucinations, understanding these symptoms and communicating them to medical professionals can save time and distress in the diagnosis process. Preventive steps and looking out for UTI symptoms should help avoid infection:

  • Drink plenty of fluids
  • Changing incontinence briefs frequently
  • Avoiding bladder irritants such as caffeine and alcohol
  • Keeping the genital area clean by wiping front to back after going to the bathroom
  • Not using douches
  • Urinating as soon as the urge hits
  • Scheduled bathroom time at least every two hours

As always, contact your physician with questions or if you suspect your loved one has a UTI.