Sudden Behavior Changes May Signal Silent UTIs

Being a family caregiver for a loved one with dementia can be extremely challenging, especially when it can be difficult to determine the cause of behavioral changes.  One common, but often unrecognized explanation of sudden changes in behavior is a urinary tract infection.  UTIs are common among people with dementia but “silent” urinary tract infections that have no ordinary symptoms may reveal themselves with anxiety, confusion, delusions, sleeping issues, or aggression. 

According to a recent Alzheimer’s Association blog post, older adults with dementia may have increasing difficulty with hygiene and personal care.   While seniors with Alzheimer’s or another form of dementia may have difficulty communicating symptoms that might indicate a UTI, sudden and significant changes in behavior may be a warning sign for caregivers.  

Older adults often become dehydrated, which can also contribute to frequent UTIs.  Elderly adults may experience burning when they urinate, frequent urges to urinate, difficulty urinating, change in smell or darkening of urine color, or fever.  Back or abdominal pain can also indicate a UTI.  But some urinary tract infections occur without any of the common physical symptoms. 

A urine test can confirm or rule out a UTI, and if positive can be treated with antibiotics.  Women, elderly men, people with limited mobility or suppressed immune systems, or blockages in the urinary tract are at increased risk for developing UTIs.  According to Visiting Nurse Services, drinking plenty of water, urinating when the urge arises, wearing cotton underwear, and showering rather than bathing can help prevent UTIs.   People who get frequent urinary tract infections may benefit from cranberry juice or Vitamin C which makes urine less hospitable to bacteria but check first with your doctor for possible drug interactions.  Avoid excess alcohol and caffeine, and urinate after sexual intercourse to reduce the risk for a UTI. 

Although urinary tract infections can usually be treated easily with a course of antibiotics, if left untreated, UTIs can lead to serious health conditions including kidney infection or sepsis.  Older adults, even without dementia, may lack common UTI symptoms due to an aging immune system.  Watch for dizziness, falling, sudden urinary incontinence, poor motor skills, or extreme fatigue which can be signs of a silent infection. 

Learn more about symptoms and prevention of UTIs in the elderly by following this link to The Geriatric Dietitian website.