Can any medical person explain to me how a bladder infection and cognitive lucidity are connected?

MissK8: A U.T.I. can cause distress for an elder including brain functionality to some extent. However, I do not profess to be a medical professional. Voice your query to your mother's physician.

My mom was constantly getting UTIs. The doctor finally put her on a low dose of Macrobid. She took it for over a year until she passed. It worked wonders.

As disease progresses, immune system strength grows weaker which is why infections, of any kind, become more regular. Any meds slowly but surely make brain disease progress faster, so beware. The bacteria causing UTI's simply go into hiding, feed off the antibiotics administered and when the dosing stops, come back stronger and more resilient and launch the next attack. Medications are not the answer. Antibiotics put more stress on the immune system so should only be used sparingly. Microbial resistance is in the top 10 of the WHO list of threats to our health. The only way forward is to give her system the right support to strengthen her immune system over time and restore system health balance.

Lucidity is affected by any infection when a person's immune system(liver) is already compromised, like now. Once the system has reached brain disease stage, infections raise blood neurotoxin levels which the liver(immune cells, not enough can be produced) to manage the attack and quell it. Blood flows through the brain and at this stage the blood-brain barrier is severely compromised, so not able to do its job of keeping neurotoxins out the brain. Brain cells are very sensitive to neurotoxins which damage them and cause short circuiting of the neurons, which is why the lucidity issues and often hallucinations occur at this time of pathogen attack.

All infections are caused by microorganisms that have multiplied in the body to cause infections. There are many different types of microorganisms - bacteria, viruses, fungi.... Each needs a different type of antibiotic to fight the infections. Some individual microorganisms are very hardy and difficult to kill and require strong medications that have unpleasant side effects. When your body fights infection with white blood cells, contents of the microorganisms "spill" into the bloodstream. Some of these are toxins that create those unpleasant symptoms we see in the elderly: confusion, lethargy, fever... If not treated an infection can progress to sepsis - a serious blood infection that can cause death. So treating an infection early and preventing infection are the best practices.

For UTIs, especially women, prevention s a never-ending process. Ladies have shorter urethras (the tube that connects the bladder to the outside of the body). That means is doesn't take as long for microorganisms to work their way from the outside to the bladder. What helps: wearing underwear that allows air to circulate around the lady parts, being vigilant about wiping front to back only (from clean area to dirty area), bathing daily and cleaning the bottoms areas through out the day, a bidet attachment to the toilet can help with cleansing the bottom every time the toilet is used, and drinking a lot of water to keep the bladder flushing out any microorganisms that make their way in. Antibiotics should be saved for infections and taken until completed. A routine of low dose antibiotics, unfortunately, creates more antibiotic-resistant microorganisms (so they are harder to kill when they multiply and cause infection).

"Metabolic encephalopathy is a problem in the brain. It is caused by a chemical imbalance in the blood. The imbalance is caused by an illness or organs that are not working as well as they should. It is not caused by a head injury. When the imbalance affects the brain, it can lead to personality changes."

This can happen as a result of a UTI.

One of the unfortunate situations in AL and Memory Care units is lack of hydration. I had a camera in my moms room 24/7 and can attest to the fact that they typically do not offer hydration between meals. If you loved one cannot remember to hydrate or is unable to get their own liquids, kidney issues and UTI's become more common. When I removed my mom from memory care she has "severe kidney issues" that the doctor said was typical in Alzheimer's disease. When I got her in a house next to me with 24 hour quality care, she no longer has "kidney issues" and doesn't get UTI's. She is given fluids throughout the day. It is essential to stay hydrated at any age. Imagine the workload for a facility with 18 residents in memory care. Keeping them hydrated all day is a job in itself and then they have to deal with all of them having to use the bathroom. Dehydration is deliberate in a lot of the facilities because of workload. Sad but true.

AlvaDeer and TChamp get kudos for supplying a scientific explanation.

https://www.cedars-sinai.org/newsroom/unlocking-the-cause-of-uti-induced-delirium

Hygiene is not the only reason why UTIs become more common in the elderly but also due to physiological changes in our bodies, like loss of muscle tone which leads to not voiding fully, or pH changes, etc.

Dehydration (or just not enough fluid intake):

"...the Institute of Medicine recommends that women have 2.2 liters daily, which is about 9 cups. Not all of this needs to come just from water — or even fluids. Fruits and vegetables, which are part of a healthy diet, contain a lot of water."

Source: https://www.health.harvard.edu/blog/more-water-fewer-utis-2018101515035

Is sugar a preventative?

"D-mannose is a type of sugar that’s related to the better-known glucose. These sugars are both simple sugars. That is, they consist of just one molecule of sugar. As well, both occur naturally in your body and are also found in some plants in the form of starch. Several fruits and vegetables contain D-mannose, including:
- cranberries (and cranberry juice)
- apples
- oranges
- peaches
- broccoli
- green beans"

Source: https://www.healthline.com/health/d-mannose-for-uti

I started giving my MIL d-mannose supplements and it cut down her incidence of UTIs by 2/3. You can order it on Amazon.

This a more specific and detailed explanation of the connection between urinary tract infection and delirium. UTI and any type of acute bacterial infection triggers an immunologic response. One protein produced by the immune system that fights the infection is called "Iterleukin-6". An exaggerated immune response produces excessive amounts of Interleukin-6, which stimulate the neurons that cause delirium. Blocking Interleukin-6, resolves the delirium.

I’m not a doctor so I can’t explain the why, but UTIs are caused by dehydration. Water is good for bodily functions and for whatever reason, if a person doesn’t drink enough water, confusion, dementia and Sundowning sets in. I have found that it’s quite difficult to get an elderly person to drink water. I don’t know why this is, but it’s very common. With my dad, we found that if he ate consistently, his dementia and confusion along with panic attacks would go away, but sometimes my dad just refuses to eat. He’s in AL and is 96. Eating and drinking water are two basics to allow us all to live better lives and keep UTI s at bay.

Im not a doctor but after my mother had her stroke my brother and I knew before she tested positive on the rapid screening test a couple of times based on her cognitive change. The way it was explained to me was that her body was giving so much energy to help her brain work and build new pathways where hers were broken that when an infection required energy focus her brain is less supported. I think of it as being like a war of sorts, you have your body’s army and a person with dementia is using 1/3 of their army (maybe more or less depending on where they are) fighting on the brain front the other 1/4 might be sending troops here or there depending on what else the patient has going on but keeping things status quo. When an infection starts developing like a UTI the body sends out most of its reserves to fend it off but since the body doesn’t have many reserves because of the brain front it can’t fend it off so as the infection gets worse it has to redirect troops leaving the brain with less support.

There are maintenance medications that can be used to help support keeping UTI at bay but they come with their own concerns so it’s a balancing act and will depend on your moms set of health issues and just how chronic her UTI’s become. My mom is diabetic and now one of the tell tale signs she has a UTI is her blood sugars are way off for no reason we can find, it seems like her body isn’t as quick to take troops from her brain and she doesn’t show signs that way as quickly but the troops come from her blood sugar balance. The medications they use as a preventative for UTI can be very hard on the kidneys and since she has kidney disease from her diabetes that’s a concern but since her high and swinging blood sugars are also hard on her kidneys they are doing blood work every six weeks or so to track if her kidney function is being affected, so far so good. I was surprised they wouldn’t just use a low dose maintenance antibiotic at her age but again it was explained to me that they hesitate to do that even in the elderly because it could make a break through UTI or another infection like CDiff very hard or impossible to treat because even at her age she can build up an antibiotic resistance. It’s a balancing act and to a large degree a crap shoot unfortunately but decisions you want to discuss with the pertinent doctors and have a good handle on the pluses and minuses before making the decision together one way or the other. What I’m saying is understand the decision if a doctor is deciding to put her on something or not put her on something and make sure they are considering the whole picture and not just throwing spackle on the problem before trying everything else including a bandaid first. Good luck, it is an adventure and a learning process!

It is my understanding ANY infection in an elderly person can cause confusion. UTIs happen to be the most common and possibly easiest to get.

The symptoms of an untreated UTI can cause behaviors that are normally associated with psychiatric conditions or substance abuse including hallucinations and delirium. A UTI is one of the first things they check for after running a drug screen at the ER when a a patient is disoriented, confused, and/or acting abnormally.

The best person who can answer this question is her doctor. Unless there is a doc in this forum, none of our answers on this question should be taken seriously.

Cranberry juice has lots of sugar Moms doctor prescribed tablets. A culture should always be done to determine what antibiotic would be best. They usually start with a broad spectrum antibiotic (says my RN daughter). Problem with that, in Moms situation, it had penicillin and she was sensitive to it. Also, when taking an antibiotic you should also be taking a probiotic to keep from getting a yeast infection.

Better to prevent them to try and get rid of them.

Good Morning Folks,

UTI's can take a toll on an elderly person. They cannot fight off an infection like a person in their 20's. If not treated it can cause havoc on their system and can be mistaken for dementia, mental illness, etc.

I give my mother a shot of cranberry juice every morning. White cotton underwear, the railings around the toilet work better than the booster seat. You can clean yourself better. Lots of water and good hygiene.

The cranberry keeps everything open. Once you get a UTI the doc will prescribe to clear. Once the UTI clears then you find the loved one's baseline. But the antibiotics present another issue especially if they are taking other medications and after a while they antibiotics they prescribe if it's too often the patient can become immune to them.

If a person sits a lot (especially in a nursing home) their bladder drops. Oftentimes the UTI may not show up on the 1st urinalysis. Also there is regular bacteria that everyone has. It's a tough call because the antibiotics can be powerful for an elderly person with a small frame but you cannot let a UTI go untreated. They will become confused, etc.

I use white facecloths, towels and underwear. Dove soap and the shower chair.

With the UTI the infection spreads to their brain and they're too old to fight it off.

Ask the doc about a shot of cranberry juice in the morning. Hope this helps.
Their nasty and can make your loved one act like a different person.

I believe the UTI-delerium link is well known in the medical field. Why? Good question..

Something to do with proteins from the immune system causing changes in the brain...?

I never knew how bad a bladder infection could be cognitively until I saw it happen in my Dad. The symptoms are unreal. The good news is, now that you've seen it in action you will recognize it sooner!

My Mom suffered from a couple of UTIs but not on my watch.

Mom must make sure she completely voids. I am finding I have to sit a little longer and I get the urge again. Leaning forward while sitting helps you to void. When she does a #2 she should use a wipe to make sure she is clean. Use no soap near the urethra. My Mom was on cranberry tablets and a probiotic. In the year before she passed she did not have another UTI.

I have never read why people get Dementia like symptoms when they get UTIs but I would think its like kidney failure, toxins are released into the blood stream and the toxins cause the process. UTIs are serious if not taken care of. They cause sepsis that can kill.

Take her to a urologist, I’m sorry , I have forgotten the name of the med, but it needs vitamin c taken as well…The urologist will know. It acts like an acid to get at where the scar tissue has pockets for bacteria to breed..my mom had chronic UTI ‘s …she would put off going to the dr knowing full well she had a uti .. when my mom started this, the UTI s stopped….

https://www.cedars-sinai.org/newsroom/unlocking-the-cause-of-uti-induced-delirium/

The above link will get you started on this one, but know that the internet is absolutely FULL of information on this syndrome.
It is quite amazing, and in all truth I was long retired from nursing before I knew a thing about this, and why many of my elderly patients were suffering as they were. We always put it down to Hospitalization-induced, but looking back I now know different.
We are but on the cusp of learning so many things about the mind.
Best out to you.