UTIs are common infections in all people. But in seniors, UTIs can cause an unexpected symptom, confusion, also called delirium. 

UTIs can cause Confusion in Older Adults

October 24th is National Senior UTI Awareness Day.  It is a great opportunity to spread awareness of this common infection with a symptom in older adults that may surprise you - confusion (also known as delirium).

What is a UTI?

Urinary Tract Infections (UTIs) are common infections.  They happen when bacteria, often from the skin or rectum, enter the urethra, and infect the urinary tract. UTIs can affect several parts of the urinary tract, but the most common type is a bladder infection (cystitis).

Another type of UTS is kidney infection (pyelonephritis).  They’re less common, but more serious than bladder infections.

Risk Factors:


Some people are at higher risk of getting a UTI. For instance, females are more common in females because their urethras are shorter and closer to the rectum. This makes it easier for bacteria to enter the urinary tract.

Other factors that can increase the risk of UTIs:

  • A previous UTI
  • Sexual activity
  • Changes in the bacteria that live inside the vagina, or vaginal flora. For example, menopause or the use of spermicides can cause these bacterial changes.
  • Pregnancy
  • Age (older adults and young children are more likely to get UTIs)
  • Structural problems in the urinary tract, such as enlarged prostate
  • Poor hygiene, for example, in children who are potty-training 


Symptoms of a bladder infection can include:

  • Pain or burning while urinating
  • Frequent urination
  • Feeling the need to urinate despite having an empty bladder
  • Bloody urine
  • Pressure or cramping in the groin or lower abdomen

Symptoms of a kidney infection can include:

  • Fever
  • Chills
  • Lower back pain or pain in the side of your back
  • Nausea or vomiting

Younger children may not be able to tell you about UTI symptoms they are having. While fever is the most common sign of UTI in infants and toddlers, most children with fever do not have a UTI. If you have concerns that your child may have a UTI, talk to a healthcare professional.

Confusion Symptom in Older Adults:

In older adults and people with dementia, UTIs can cause sudden confusion (also known as delirium).  If the person has a sudden and unexplained change in their behavior, such as increased confusion, agitation, or withdrawal, it could be because of a UTI.

The person may not be able to communicate how they feel, therefore it is helpful to be familiar with the symptoms of UTIs and seek medical help to ensure they get the correct treatment.  Infection could speed up the progression of dementia, so all infections should be identified and treated quickly.

Diagnosis:

Talk to your care provider if you have have symptoms of an UTI or for any symptom that is concerning.  Sometimes other illnesses, such as sexually transmitted diseases, have symptoms similar to UTIs. Your healthcare professional can determine if a UTI or different illness is causing your symptoms and determine the best treatment.   Your healthcare professional will determine if you have a UTI by:

  • Asking about symptoms
  • Doing a physical exam
  • Ordering urine tests, if needed

Treatment:

UTIs are caused by bacteria and antibiotics are used to treat them.  However, any time you take antibiotics, they can cause side effects.  Call your healthcare provider if you develop any side effects while taking your antibiotic.  

Drink plenty of water while you recover. Your healthcare professional might also recommend medicine to help lessen the pain or discomfort. Talk with your healthcare professional if you have any questions about your antibiotics or other medicines.

 

Prevention:

You can help prevent UTIs by doing the following:

  • Urinate after sexual activity
  • Stay well hydrated
  • Take showers instead of baths
  • Minimize douching, sprays, or powders in the genital area
  • Teach females to wipe from front to back when potty training

Learn more:

CDC UTIs 

Alzheimer's Society 

Urinary Tract Infection Induced Delirium in Elderly Patients

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