I see all over the message board when a patient has a downward turn or "episode" of any kind, many many people refer to UTI's as being an underlying cause. I understand from experience that trauma either emotional or physical can and will affect the patient's abilities and often precipitate a decline in function. A uti although left untreated can become a serious condition is relatively minor. Why don't we see this kind of connection being made with the common cold or the flu which seems to be a more frequent occurence.

Hi Pam,

I am not a Care Consultant but I was an RN.

Many people, especially elderly people, when they get a UTI whether silent or with symptoms, tend to get pretty sick fairly quickly. A very common symptom of a silent UTI is changes in behavior like confusion or decline. I think this is why you have been reading about it on these boards.

Hope this helps.

Dear Pam W,

Your question is a very interesting one. Unfortunately, I don't feel qualified to answer it in a meaningful way. Whatever I said would be pure speculation. The human brain is so complex and, although research is revealing more and more about it's functioning, there is so much we don't know. Also, the effect of AD on any person's thinking and behaviors is so individual that it is difficult to generalize.

What you said about physical and emotional trauma and UTIs often causing or exacerbating behavioral disturbance in persons with dementia is very true, and it is curious that common colds and the flu do not often have the same effect. But I wouldn't pretend to understand why that is so. You might want to present this issue on the caregiver's forum to elicit opinions from others, or speak with a medical professional for their opinion.

Good luck.

Charlie

I'm not sure that there is any direct correlation between AD and UTI's. The symptoms of a UTI are entirely different in an older person than in a young person. Young people feel pain, but old people have dramatic behavior changes.

The only time my mother had a UTI in her elder years, I thought she was stark raving mad. She had wild delusions, wouldn't sleep, wouldn't drink which led to dehydration, high blood sugar and low potassium. She spent 3 days in the hospital just to get the chemicals in her body in balance. Because of the deyhdration, she could have had a stroke or heart attack. I feel that every time she gets dehydrated, she looses a lot of ground in her battle with dementia.

The elderly in general and especially those with dementia (because of lowered level of cognitive reserve) are susceptible to delirium. In dementia, UTIs cause a mild form of delirium that produces a decline in function and increase in confusion.

de•lir•i•um. A temporary state of mental confusion and fluctuating consciousness resulting from high fever, intoxication, shock, or other causes. It is characterized by anxiety, disorientation, hallucinations, delusions, and incoherent speech.

Google - dementia UTI delirium

Inflammatory Response To Infection And Injury May Worsen Dementia
http://www.sciencedaily.com/re.../09/080916215205.htm

Double trouble: When delirium complicates dementia
http://www.nursingcenter.com/p...ticle.asp?tid=812348

Dementia Versus Delirium
http://www.selfhelpmagazine.co...le/dementia-delirium
“Delirium can be caused by virtually any medical condition. A urinary tract infection, reaction to drugs, low blood pressure, dehydration, even sensory deprivation for hospitalized patient.”

“Delirium is a true medical emergency.”

(My note - the level of delirium caused by a UTI is not as severe as when caused by a more major illness and would not rise to the level of a “medical emergency”, but would produce a change of behavior.

Look at it another way, anything that produces stress on the body of a person with dementia will cause an increase in confusion and possible behavior issues. UTI, pain, dehydration or exhaustion will produce such results.

The complicating issue in dementia is that we can tell when they have a fever (from flu) or a cold, but they cannot or do not tell the caregiver that they have a UTI. And in dementia, they can have a silent UTI which does not exhibit the traditional symptoms.

My dad has had AD for 4 years. He was diagnosed with a UTI 3 weeks ago, after he became more confused and started blinking his eyes rapidly. He took anti-biotics and the urine tests all say he is "cured." But he has gotten worse behaviorally. He has lost 15 pounds. He won't eat, says he "can't" (although we HAVE given him food and liquids and even his pills and he swallows without any problem). He is in the hospital on IVs but still won't eat. My question is: did the UTI cause a permanent decline into the last stages of AD? Has anyone seen this?

with this disease any number of bad things are possible, but i would also ask him to be checked again for a uti, checked for pneumonia, and evaluated for acid reflux and constipation. there are a number of reasons to not want to eat, and with alz it can be very difficult for the LO or their family to know the causes.

Dear SalBolal,

I am so sorry for the quick changes you have seen in your father. This disease is so unpredictable. It can feel good to know what is happening and why and hurt so much to not know why such changes are occurring.

In some cases, persons who have other medical problems affecting their dementia symptoms see a change in their disease progression. In many cases it will go back to how it was before the infection, but there are cases that the changes may seem to be the new normal. But, as vhj had mentioned, there very well could be another medical condition affecting your father, or perhaps the UTI is still present. Please work closely with the staff at the hospital and his physician who follows his dementia. Let them know you are concerned this is more than the dementia, and ask for further testing for infections and other issues.

Your father has had a lot going on in the past couple weeks. He has had an infection, been in the hospital and out of his home environment, he has been meeting new people, having tests, eating different foods, etc. All of these environmental changes can play a big part in the symptoms of dementia. Stability is important in dementia, and can help reduce sudden changes and confusion. When a person with dementia has a shift in their day to day routine on top of having an infection or possible other medical condition, changes are often noted. It may help to bring in some familiar items from home while he is the hospital. And attempt as best you can to make his routine something familiar. Bring in some family albums and talk about those things that interest him the most.

Work with the doctor closely about assisting with eating and drinking. If he is saying "no" he does not want to eat, this may be his way of letting everyone know he is not comfortable and may be in pain specifically in his stomach area. But, this denial of food and liquids may be a behavioral change which goes along often with infections. Please work closely with the staff regarding all the changes you see, and what can be done to make sure he eats, and is in a stable environment. Some families find that anti depressants or anti psychotics help to regulate the mood changes and may assist with certain problematic behavioral changes.

I am so sorry you are going through this quick change. It is such a scary process to not know why something is happening in this way. Please know that we are here for you anytime you wish to talk more about what is happening. Call us anytime at 800.272.3900. We are here to help.

Bests,