Is There a Link Between Urinary Tract Infections and Dementia?

Urinary tract infections (UTIs) are common in older people. According to a study by the National Institutes of Health, over 10% of women over 65 reported having a UTI within the previous 12 months; for women over 85, the percentage was 30%. While urinary tract infections are more common in women than men, men can get them, too. 

Urinary tract infections may cause delirium and disoriented thinking in older patients that can look like Alzheimer’s or other dementia. Is there a connection between urinary tract infections and dementia? 

What is a Urinary Tract Infection?

A UTI is an infection in any part of the urinary system, also called the urinary tract. It is caused by bacteria entering the urinary tract via the urethra, through which urine passes from the bladder and is voided from the body. A UTI that infects the bladder is called cystitis; in the kidneys, a UTI is called pyelonephritis. Symptoms depend on which part of the urinary tract is affected. 

The reason women tend to have more UTIs than men is that women have shorter urethras, which means that bacteria have a shorter distance to travel to the bladder and cause infection. Women’s urethras are also located in closer proximity to the anus, and potentially more exposure to bacteria. 

Risk factors for UTIs include catheter use, a weakened immune system, and poor hygiene. Enlarged prostate in men or prolapsed uterus, bladder, or bowel in women is also associated with a higher risk of UTI.

What are the Symptoms of a Urinary Tract Infection?

Symptoms of an infection in the lower urinary tract (urethra and bladder) include:

• Pain or burning when passing urine
• The feeling of needing to urinate urgently
• The feeling of not being able to completely empty the bladder
• Cloudy, bloody, or foul-smelling urine
• Lower abdominal pain
• Urinary incontinence
• Low fever (up to 101 degrees F)
• Delirium or acute confusion

An infection in the upper urinary tract (ureters and kidneys) is more serious, and potentially life-threatening. In addition to the symptoms above, an upper urinary tract infection may cause:

• Nausea or vomiting
• Shaking or chills
• Back or side pain
• High fever (over 101 degrees F)

Lower UTIs are often treated with a three-day course of antibiotics; for an upper UTI, a 7- or 14-day course may be required and hospitalization may be needed.

What is UTI-Related Delirium?

Delirium is a change in a person’s mental state with a relatively quick onset, typically a day or two. Delirium may manifest as confusion, difficulty with concentration, memory problems, agitation or restlessness, changes in sleep patterns, or even hallucinations or delusions. 

These symptoms may fluctuate in severity over the course of a day, but they are understandably alarming to family members. Treatment of the urinary tract infection should cause symptoms of delirium to resolve, but in some serious cases, antipsychotic medication may be needed.

What is the Connection Between Urinary Tract Infections and Dementia?

Studies on dementia and urinary tract infections suggest that UTIs do not directly cause dementia, but there are some links between the two. 

People with dementia may have a harder time communicating that they are experiencing UTI symptoms like burning on urination or an urgent need to urinate. That makes it harder to promptly diagnose the condition, which means treatment is delayed and the UTI has a chance to become more severe. If someone already has dementia, UTI-related delirium may not be as immediately noticeable. 

Many of the risk factors for UTI, such as weakened immune system and less-effective bladder function, are also common in individuals with dementia. While there is no evidence that even frequent UTIs cause dementia, it is still important to be alert to the signs of a urinary tract infection and seek prompt treatment. 

Best Practices for Minimizing UTI Risk or Managing UTIs

It is important that people who are at risk of urinary tract infections drink plenty of water; that helps to flush out bacteria in the urinary tract before an infection can take hold. Staying well-hydrated is also important in the management of an existing UTI, but patients with a UTI may be hesitant to drink a lot of liquid because they fear painful urination. 

It’s also important to encourage regular bathroom visits to prevent the growth of bacteria in the urinary tract, and proper cleaning after using the bathroom (wiping front to back only). The Mayo Clinic also suggests that cranberry supplements may be helpful to prevent UTIs.

Ensuring Proper Care for an Older Loved One

If you are concerned about the health of an aging loved one, an elder law attorney can help you identify ways to put supports in place to protect their well being whether they live at home in assisted living, or in a nursing home. An elder law attorney can also assist your loved one with estate planning and incapacity planning. 

To learn more about urinary tract infections and dementia, contact us today. Our elder law team can connect you with resources to keep your family member in the best possible health and address their ongoing physical and mental health needs.