is it dementia or a silent utiAnyone who has experienced a UTI (urinary tract infection) in their youth will tell you that it has distinct physical symptoms, such as pain, burning, frequency, and pressure. In fact, given time, a UTI is too painful to endure without medical intervention. This is often not the case with an older adult. Frequently none of these symptoms exists. Instead, the elderly may suffer from a “silent UTI” because the “normal” signs do not exist. There is no pain or pressure that drives younger people to seek treatment, and without treatment a UTI can quickly become life threatening.

For the elderly a silent UTI can show the following systems instead of pain: confusion, agitation or withdrawal from social interaction with others. With a UTI this change in mental functions is usually sudden. Caregivers often perceive these symptoms in the elderly as the onset or increase of dementia and in many ways it seems as it is. However if a person is not able to complete tasks they were able to do two days ago or is significantly disoriented more than a few days ago, then a UTI should be suspect. It is unlikely that dementia is the cause. Another symptom is an increase in incontinence, but even if this symptom is absent, a sudden change in cognitive ability should motivate you to contact a doctor and to check for a UTI.

UTIs are easy to get and some people get several each year. They are the second most common type of infection and account for about 8.3 million doctor visits a year, according to the National Center for Health Statistics. Although easy to cure, if left untreated UTIs can lead to kidney infections, sepsis, and death. Anyone can develop a UTI, but those with diabetes, kidney stones, or those who use a catheter are at greater risk.

Do not assume that your doctor is aware that UTIs in the elderly can mimic dementia. If you or your loved one has had a sudden change in cognitive ability or incontinence, then insist on a urinalysis. If UTIs are occurring frequently, ask your doctor to explore what may be causing you to have so many. There may other medical issues that are contributing to frequent UTIs,  and often ultrasounds, x-rays or CAT scans may be needed to discover the cause..

You can significantly reduce your chance of getting a UTI if you practice the following behaviors:

  • Do not hold your bladder. Urinate promptly after you sense your bladder is full.
  • Wipe from front to back when going to the bathroom (If this is not possible, due to physical limitations, then wipe from side to side. Never wipe from back to front.)
  • Avoid using feminine products, such as powders, douches or deodorant sprays
  • Empty the bladder directly before and after intercourse
  • Choose to shower instead of taking baths
  • Drink plenty of water frequently