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The Link Between UTI and Dementia in Older Adults

Your elderly loved one with dementia may suddenly start displaying more severe behavioral symptoms of this disease and you may wonder why. There could be a simple reason behind it all. They could have a urinary tract infection, or UTI. This is a very common phenomenon in elderly dementia patients. Even if your loved one hasn’t officially been diagnosed with dementia, you may notice that dementia-like symptoms, such as confusion, come on fairly quickly. Often, this can be traced to the development of a UTI. Whether your loved one is being cared for in a nursing home, in home care, or in hospice, you may wonder why this link exists. Let’s explain why.

According to, if a senior patient already has dementia, a urinary tract infection (UTIs) may cause behavior changes instead of the physical symptoms that may plague a younger person. Whereas most otherwise healthy people display physical symptoms like burning when urinating, elderly patients may not complain of such pain. However, they may start to behave erratically, which is usually what tips off health care providers. If not detected early, infection can lead to serious health problems.

Defining UTIs

First off, a UTI can result when bacteria enter the urethra and travel to the bladder and kidneys. The NIH says nearly four times as many women get UTIs as men, as females have shorter urethras, making it easier for bacteria to reach the bladder. Other risk factors include having diabetes, kidney issues and a weak immune system.

Symptoms in younger people include a strong, persistent urge to urinate, a burning sensation while urinating, passing small yet frequent amounts of urine, pelvic pain in women, and strong-smelling urine, according to the Mayo Clinic.

Women who have gone through menopause are at a higher risk for UTIs because they don’t have as much estrogen in their system. As a matter of fact, estrogen helps prevent the growth of bacteria within the urethra.

Physicians typically will diagnose a UTI via the following:

  • Urine test
  • Ultra-sound exam
  • X ray
  • CAT scan

Most people who get a UTI complain of painful urination, fever, chills or lower back pain, but dementia patients often do not. That’s why it takes careful observation by health care providers and family members to bring unusual behavior to the attention of the medical staff. This behavior can include confusion, agitation or withdrawal. Your loved one may start telling fantasy stories, or insist something happened when it clearly did not. Manic episodes, yelling, crying, delirium, or other unusual behaviors may be present.

As treatment, antibiotics are typically given to clear up the infection. Dehydration is also a factor, so fluids are administered as well. If left untreated, the infection can spread to the blood stream and become life-threatening. Routine illnesses in otherwise healthy people can be deadly in the senior population.

UTI and Dementia

It’s important to note that while UTIs can exacerbate dementia symptoms, they don’t always mean a person has dementia or signal a risk factor for Alzheimer’s. So why do seniors seem to respond so differently to UTIs? It is thought that because our immune systems are altered as we get older, they respond differently to such infections. So, rather than pain symptoms, elderly people with UTIs may start acting more erratically and troublesome than usual. As their daughter, son or other loved one, you may be able to pick up on these signals fairly quickly after awhile.


You may notice some of the following symptoms start to display in your loved one, signaling a change in mental state.

  • Agitation
  • Restlessness
  • More difficulty concentrating
  • Hallucinations
  • Extreme fatigue
  • Becoming withdrawn
  • Tasks they could do before are suddenly not as easy
  • Sudden urinary incontinence or leaking
  • Cloudy or even pink or brown colored urine
  • Strong odor to the urine

The most important thing to remember about the link between UTI and dementia is that the behavior change is significant and happens fairly quickly, usually over a period of one to two days. Falls, recent incontinence or loss of appetite can all be signs of a UTI infection, according to Daily Caring.

Another important thing to remember is that your loved one may not be able to communicate how they feel, or that something is “off.” They rely on you and their home health care or medical team to pick up on those signals and provide treatment. That’s why your feedback and input is so valuable.

Contact Pathways Home, Health and Hospice

Our home health care and hospice teams work together to stay on top of issues like UTIs, and get them diagnosed and treated quickly. Contact us at 888-755-7855 to learn more about our team as well as our services designed so your loved one gets competent, well-rounded care.