A Urinary Tract Infection May Cause an Older Person to be Confused
Prevalence of UTI in the Elderly
Urinary tract infections, with or without symptoms, are quite common in the elderly.
- According to a 2005 article in Drugs Aging by Florian M.E. Wagenlehner et. al. entitled Asymptomatic Bacteriuria in Elderly Patients, 20-25% of women and 10% of men over the age of 65 experience asymptomatic bacturiuria.
- People over 80 years are even more likely to develop asymptomatic bacteriuria: over half of women and over a third of men.
- According to The Merck Manual of Geriatrics, as many as 10% of all elders have symptomatic UTIs.
Asymptomatic (without symptom) UTIs in the elderly are usually not treated unless the benefits outweigh the risks, but recognizing and properly treating a symptomatic UTI in an elderly person may help prevent more serious infections and complications.
Common Symptoms of UTI in Elders
- Painful urination
- Frequency or more frequent urination
- Incontinence or incontinence that is unusual for that person
- Flank pain
- Confusion or delirium
Common Risk Factors for UTI in the Elderly
- Use of urinary catheters
- Living in a long-term care facility or nursing home
- Hormonal factors such as estrogen deficiency in women
- Anatomical factors such as an enlarged prostrate in men or a cystocele in women
- Functional factors such as Parkinson’s disease or dementia
- Metabolic factors such as diabetes
- Factors related to immunity such as increased cytokines and acute phase proteins
Measures to Prevent UTI
Prevention is the best and safest approach.
- Limit the use of chronic indwelling catheters
- If a catheter is necessary, perform appropriate catheter care and consistently use appropriate infection control guidelines while maintaining a closed drainage system.
- Recognize and replace an obstructed catheter.
- Prevent catheter trauma, such as pulling on tubing with a transfer from bed to chair.
- Employ generally accepted hygienic measures, such as keeping the perineal area clean and dry and wiping from front to back.
- Oral lactulose showed promising results in a study published in the 1989 Journal of Hospital Infections entitled Lowered prevalence of infection with lactulose therapy in patients in long-term hospital care.
- Intravaginal estriol is often recommended for postmenopausal women with recurrent UTIs due to studies showing significantly lower rates of UTI with the use of estriol.
- Certain vaccinations may be recommended for special populations.
- Future studies are focusing on developing materials in urinary catheters that resist biofilm formation, according to a 2005 article in Drugs and Aging entitled Catheter-related urinary tract infections by Lindsay Nicolle.
Confusion May be Reversed
Is sudden confusion permanent? The answer to that may depend on whether or not and how quickly a cause is determined. Caregivers of the elderly should be particularly watchful for changes in an elder’s mental status and should contact a healthcare provider of any acute confusion or sudden worsening of existing confusion. Ruling out a UTI would be an appropriate early step if an elder suddenly became confused or had worsening confusion. Early treatment of a symptomatic UTI may prevent more serious symptoms and complications and can quite possibly result in a return to the elder’s normal mental status.Source:http://seniors-health-medicare.suite101.com/uti_may_be_cause_of_sudden_confusion_in_elderly