An Important Link Between Bladder Infections and Dementia

Pills on a bedside table
As we age, our immune systems tend to get weaker, making us more vulnerable to infections of all kinds. One of the most common infections in elderly people is a urinary tract (UTI) or bladder infection. A UTI can happen at any age, but there’s another thing that comes with advanced age that increases the risk. Bladder infections are more likely to occur in people who have trouble totally emptying their bladders. That’s because the longer urine sits in the bladder, the more time bacteria have to grow.

For several reasons, it’s usually more difficult for elderly people (men and women) to completely empty their bladders.

  • Side effect of certain medications, e.g., antihistamines, tricyclic antidepressants and medicines to treat stomach and muscle cramps.
  • Prostate problems
  • Bladder prolapse after menopause
  • Incontinence

The usual symptoms of a urinary tract infection are:

  • Difficulty urinating
  • Increased frequency
  • Increased urgency
  • Blood in the urine
  • Fever (sometimes)
  • Abdominal pain (sometimes)
  • Incontinence

The problem is, many times elderly people don’t have such clear cut symptoms. If an elderly person also has dementia, it may be difficult or even impossible to communicate that they don’t feel well. That’s why it’s important to be pay attention to other possible signs of an infection.

  • General weakness
  • Fatigue
  • Malaise — just doesn’t seem to feel well
  • Sudden or worsening incontinence
  • Sudden change in behavior

That last bullet point — sudden change in behavior — is especially important to recognize and understand. If an elderly person suddenly shows signs of delirium — acts confused and disoriented — it could mean he/she has a urinary tract infection (or some other infection).

When someone is already confused and disoriented because of Alzheimer’s disease or another cause of dementia, it might be easy to think the dementia is simply progressing. Again, an infection might be the cause, so it’s important to have it checked out right away.

The difference between delirium and dementia

The symptoms may seem similar, and delirium is certainly common in people with dementia, but there is a key difference. Delirium is usually sudden and acute, whereas dementia happens more slowly and progressively.

Courtesy of Mayo Clinic, here are some differences between the symptoms of delirium and dementia

  • Onset
    •  The onset of delirium occurs within a short time, while dementia usually begins with relatively minor symptoms that gradually worsen over time.
  • Attention
    • The inability to stay focused or maintain attention is significantly impaired with delirium. A person in the early stages of dementia remains generally alert.
  • Fluctuation
    • The appearance of delirium symptoms can fluctuate significantly and often throughout the day. While people with dementia have better and worse times of day, their memory and thinking skills stay at a fairly constant level during the course of a day.

What you can do

Anyone who cares for an elderly person with dementia, which includes our caregivers at Advantage Home Care, has to be aware of and sensitive to sudden changes in behavior, mood or personality. It’s easy to assume a change is simply another sign of the dementia, but too often the cause is actually a bladder infection. Caught early, it can usually be easily treated and symptoms, including delirium, go away. Untreated, the infection could spread and cause much more serious problems.

If you have a topic you’d like to know more about or think would be suitable for the Advantage Home Care Blog, please let us know. We are always looking for good ideas.

This blog is written by Diane Atwood, who also writes a health and wellness blog called Catching Health with Diane Atwood.

Originally posted Oct 16, 2013

Categories: Alzheimer's/Dementia and Blog.

Comments

  1. Genoa

    I don’t understand when my mother shows signs of a UTI, why the nursing home waits for family to request her to be tested.

    • Diane

      Genoa,
      My advice would be to have a conversation with the person in charge of your mother’s care and if you’re not satisfied, speak to a nursing supervisor. Find out what their protocol is for handling suspected UTIs. Also, I’m sorry it took so long to respond to your question. I usually get an email notification when someone comments, but don’t recall seeing one about yours. I hope your mother is doing ok now.
      Diane

      • Mark Granata

        Hi Diane
        My wife 59yrs old was first diagnosed with Aphasia thrugh cognitive testing. I was not satisfied with this answer that our neurologist gave my wife and
        He also recommended us to a study group that conducted a series of imaging and did say that my wife indeed has plaques and tangles through imaging
        My question to you Diane is should my wife be tested for UTI even though she seams fine
        Concerned husband
        Mark

  2. We feel my mom has the beginning stages of dementia she was sent to a neurologist and he said “yes she does have a touch of it but when things go back to her normal life it goes away” he said call me if it does not get better and that was it……We were not satisfied.

    We are labeling it sundowners she is fine till the sun goes down then she begins to accused family of having sexual activity and stick with story…….we are very baffled and quite bit embarrased where to turn from here…..don’t know

    if you can direct me to any type of assistant my family will be greatly appreciated

    HELP

    • Diane

      Pat,
      I don’t know where you live, but here in the Portland area, the Maine Medical Center Geriatric Center does comprehensive assessments. A few years ago, my mother was diagnosed by her family doctor with mild cognitive impairment and when her symptoms progressed we took her to the Geriatric Center where they did a thorough evaluation and told us she had Alzheimer’s. It was extremely helpful. She is now living in a memory care facility in her community and her primary care doctor happens to be a geriatrician who specializes in dementia. The Alzheimer’s Association is a great place to find useful information and it has a 24/7 helpline if you need to talk to someone: 1.800.272.3900. Also, here is a link to information about various dementia services throughout Maine that I think will be helpful: http://www.maine.gov/dhhs/oads/
      Good luck and know that you’re not alone.
      Diane

  3. Charlie

    Our 97 year old Nan is suffering with dimentia and is being cared for by my parents. Although still physical and in good health for her age she is visting the bathroom all the time? In the space of 10 minutes today she went 4 times and approx 15 times during the night. She does urinate when she goes so it’s not like she’s forgotten shes gone or just has feeling to go? Could this be an infection?

    • Diane

      Charlie, I’m not a medical professional, so I couldn’t tell you for sure. My advice is that if you’re worried, it should be brought to the attention of her medical provider.

  4. In your article, you stated that bladder infections are more likely to occur in people who have trouble totally emptying their bladders. My mom called me last night because she was having a lot of issues with going to the bathroom and was in a lot of pain. Does the medicine that can be prescribed for this issue depend on the person’s age?

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