Dementia and UTIs

What’s the Link Among Urinary Infections, Dementia and Falling?

Urinary tract infections (UTIs) are common among elders with dementia. A urinary tract infection occurs when bacteria enter the urinary system. Abnormal changes to the urinary system may also affect a person’s ability to release urine. When urine sits in the bladder for too long, this increases the risk of a UTI. These problems may be caused by an enlarged prostate or prolapsed pelvic organ. In persons with dementia, the risk of a UTI is higher, as their ability to take care of their personal hygiene diminishes. Antibiotics are the standard course of treatment for a urinary tract infection, and generally resolves the problem.

However, UTIs are often misdiagnosed or overlooked in individuals with dementia. Why?

• It may be difficult for individuals to verbalize that something is going on to indicate a urinary tract infection (such as a “burning feeling” while urinating and an increased need to urinate).
• UTIs can lead to confusion, disorientation or delirium. These problems may also make it difficult for individuals to explain the problem.
• Caregivers and family members may notice changes in behavior, which are often ascribed to worsening dementia, rather than an underlying UTI.

If the UTI goes unrecognized and untreated for too long, it can spread to the bloodstream and become life-threatening.

Aside from common signs of a UTI (abdominal or back pain, cloudy or foul-smelling urine, etc.), which may or may not be present, UTIs in persons with dementia often present with loss of balance and frequent falls. Other common problems include:

• Changes in behavior, such as aggression.
• Changes in appetite.
• Trouble sleeping.
• Increase in confusion or disorientation.
• Decline in function/mobility.

It’s important that family caregivers seek a proper medical evaluation if any of the above problems occur. Knowing the signs of UTIs in loved ones with dementia can help them get treated early, before the infection leads to serious health problems.

Tips to Reduce UTI Risk 

• Monitor fluid intake — encourage the person to drink six to eight glasses of water a day.
• Prompt the person to use the bathroom several times a day — approximately every two to three hours.
• Avoid constipation — this can prevent the bladder from emptying properly, which can cause a UTI; eating foods high in fiber, drinking plenty of liquids and exercising helps prevent constipation.
• Maintain good hygiene; shower/wash the genitals at least once a day.