Urinary tract infections are one of the most common conditions urologists treat, with women being especially vulnerable. Scientists estimate 50-60% of adult women will contract a UTI in their lifetime, with older women among the most susceptible to this type of infection.
The good news is that they are highly treatable.
Common Symptoms
Patients commonly suffer some or all of the following symptoms:
Burning sensation when urinating
Frequent, persistent need to urinate
Cloudy or strong-smelling urine
Red or pink urine (which indicates there may be blood in the urine)
Tenderness in the lower abdomen, above the pubic bone
Most doctors agree that if a patient has at least two of the symptoms above in addition to a positive urine culture, it’s time to treat them for a UTI.
But more alarming cognitive symptoms like confusion and delirium can also accompany a UTI in seniors. Most people aren’t aware of the connection between this type of infection and cognitive issues and may worry their loved one is showing signs of dementia.
And sometimes, delirium can be the only symptom, making it all the more difficult to diagnose.
What Is UTI Delirium?
Medically speaking, UTI delirium can look like disorientation but is different from dementia or Alzheimer’s in that it generally comes on quickly— within days or sometimes even hours vs. over the course of months or years.
And confusion isn’t the only symptom that can accompany a UTI in seniors. Sometimes seniors with this condition can seem aggressive, restless, or withdrawn. And in more extreme cases, they may experience hallucinations.
How Does a UTI Affect The Brain?
So how does a UTI cause delirium, confusion, or hallucinations? It’s a urological condition, not a neurological one, right?
Scientists haven’t yet confirmed a direct link between UTIs and cognitive impairment but there is strong evidence to suggest it has to do with inflammation.
When we contract any infection (including a UTI), our body’s immune system ramps up into high gear to help fight it off. In this process, our system releases chemicals and stress hormones, which can trigger inflammation.
And inflammation can result in symptoms like fever and fatigue, as well as delirium or confusion in older adults. But why?
As we age, the blood-brain barrier (which protects the brain from things like viruses, bacteria, or fungi) becomes weaker and so infection and inflammation have greater opportunity to affect our brain’s normal function.
It’s important to remember, not all seniors experiencing delirium have a UTI, and not all UTIs result in confusion and disorientation.
Can There Be an Underlying Cause For Chronic UTIs?
While in many cases the diagnosis is pretty straightforward and only a urine sample is needed to confirm the infection, sometimes UTIs are secondary to larger issues.
In both men and women, things like constipation and kidney stones can prevent the bladder from emptying properly, creating a breeding ground for bacteria to grow.
An enlarged prostate gland in men can be responsible for recurrent infections, while a prolapse of the womb or vagina could be the hidden cause of chronic UTIs in women.
Additional risk factors may include things like the use of a catheter, a diabetes diagnosis, or the presence of kidney stones.
Treating a UTI In Older Adults
After an exam and confirmation of a UTI, your urologist will likely consider prescribing antibiotics. Most will prescribe a narrow-spectrum antibiotic (meaning, one that is only able to kill or inhibit a limited species of bacteria, like amoxicillin) since older adults don’t typically need powerful antibiotics for UTIs.
Drugs commonly recommended for simple UTIs include:
Trimethoprim/sulfamethoxazole (Bactrim, Septra, others)
Fosfomycin (Monurol)
Nitrofurantoin (Macrodantin, Macrobid)
Cephalexin (Keflex)
Ceftriaxone
Over-the-counter medicines like ibuprofen can help ease pain as well as bring down a fever.
A course of narrow-spectrum antibiotics will clear most infections quickly. If after a few days a patient is still experiencing symptoms, they should make an appointment with their urologist to explore further treatment options.
If you have or suspect you have a urinary tract infection, why not talk with the physicians at Norman Urology?
We are experts in our field and have extensive experience treating urological conditions including UTIs and the underlying factors that can cause them.
We’d love you to make an appointment with us today to learn more!