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Sudden Change in Behavior? Urinary Tract Infection Could Be the Cause

Sudden Change in Behavior? Urinary Tract Infection Could Be the Cause
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October 21, 2011
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This post was updated in March 2020.

UTIs, or urinary tract infections, can cause changes in people living with Alzheimer's disease and other dementia. As a care consultant with the Alzheimer’s Association’s 24/7 Helpline, I often speak to people about possible urinary tract infections (UTIs). UTIs are common among people diagnosed with Alzheimer’s and other dementia. This is attributed to age and partly due to increasing difficulty with hygiene and personal care.

Since the launch of ALZConnected, more than 98,000 individuals have registered for this free, online community for people living with Alzheimer’s and other dementias and their caregivers.

If you search the Caregivers Forum on ALZConnected and type in “UTI”, you will pull more than 8,000 posts on our message boards.

Here is a sampling of some of the posts on the topic:

  • “For me, falling and hallucinations always mean check for UTI.”
  • “Our compromised elders, especially females often develop, "silent" urinary tract infections. These UTIs are called "silent" because they usually have no symptoms of pain, no burning, no odor, no frequency, etc. BUT there will often be profound changes in behaviors.”
  • “UTI, UTI, UTI, UTI, UTI! When my mother has a UTI she sleeps all day. We can't get her out of bed, she will also stop eating. Have the doctor check her for a UTI."
  • “UTI and dehydration!!!!! I've never been so happy to get that kind of diagnosis. They have her on IV antibiotics. The interesting thing was that her urine was clear and they were pretty sure she didn't have a UTI. Luckily the testing came back positive.”
  • “With my aunt, I could always diagnose the UTI because she started acting crazier than her current norm. (When she picked up a glass of water and threw the water over her shoulder, I called it right away — UTI.)”

Signs of a UTI
There are various signs and symptoms of a UTI, which can occur in women and in men. People with a UTI may experience burning when they urinate as well as a frequent intense urge to urinate. They may also have back or abdominal pain. 

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Family members and caregivers may notice difficulty urinating, change in urine smell, darkening urine color, and fever. However, some UTIs present without clear symptoms. 

Detecting UTIs can be difficult, particularly with someone whose communication may be impaired due to dementia. Sudden changes in behaviors and an increase in symptoms may indicate that your loved one has a UTI. Behavior changes and causes that seem to affect one’s personality may include sleeping issues, anxiety, depression, confusion, aggression, delusions, hallucinations and paranoia.
Getting Help
When UTIs wreak havoc, we sometimes see message threads in which caregivers are in a state of panic about the symptoms. And for good reason — the symptoms are powerful and can actually mimic the end of life for some people. Getting a urine test may not be the first thing you think of when your loved one starts behaving so differently, but these changes often occur with a UTI due to fever and increased pain. When you see sudden behavioral changes, it is important to rule a UTI out and consult with a doctor. 

Typically the natural progression of Alzheimer’s and other dementia diseases is gradual. Generally, once the UTI has been treated with antibiotics, the person returns to their baseline and no lasting harm is done. 

If you have questions or concerns about changes you are observing in your loved one, don't hesitate to reach out to us at the Alzheimer’s Association 24/7 Helpline: 800.272.3900. 
This post was provided by R. Clinton, a care consultant with the national office of the Alzheimer's Association.

Related articles:
Alzheimer's and Aggression

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