UTIs Cause Unique Mental & Behavioral Symptoms in Older Adults

Sophie Bebeau

Written by Sophie Bebeau on Wed May 03 2023.

Women holding hands.

A urinary tract infection (UTI) is an infection that occurs when bacteria enter the urinary system. The urinary system includes the kidneys, ureters, bladder, and urethra. Most UTIs occur in the lower urinary tract, which includes the urethra, where urine drains from the body, and the bladder, where urine is stored.

If you’ve ever had a UTI, you probably know the distinct pain and discomfort associated with it. Or remember the frequent need to urinate, the burning sensation, and sometimes even the stomach or pelvic pain that comes with it. 

Urinary tract infections are incredibly common. They are the second most common type of infection in the United States, causing more than 8 million doctor visits each year. According to the American Urological Association, about 10 in 25 women and 3 in 25 men will experience symptoms of a UTI in their lifetime.

But did you know that the risk of urinary tract infection significantly increases as we age? A weakening immune system, more health conditions, and a higher chance of dehydration and immobility contribute to a greater risk of UTI in older adults.

Over 10% of women 65+ will report a UTI each year, and that percentage increases to 30% for women over 85. Though urinary tract infections are more common in women, the risk for UTI in men also increases substantially over age 65.

But UTIs don’t just increase as we age; they also change how they affect us. While physical symptoms may still be present, UTIs in older adults often take on a new set of behavioral and mental symptoms.

Unique UTI Symptoms in Older Adults

Imagine you’re caring for your aging mother; one day, she seems more confused, disoriented, and agitated than usual. Perhaps she’s having trouble remembering things or even seeing things that aren’t really there. 

Would your first thought be a urinary tract infection?

Most family caregivers are aware of the possibility of UTIs in older adults but don’t know the unique mental symptoms that appear in seniors with UTIs.

It can be harder to detect a UTI in older adults because they don’t always show the most common physical signs or may be unable to express them accurately. In addition, the mental symptoms that often accompany UTIs in older adults can also be subtle and attributed to other conditions, such as Alzheimer’s or dementia.

Mental Symptoms & Signs of a UTI in Older Adults

Some of the most common mental symptoms and warning signs in seniors who have a UTI are:

  • Sudden change in cognitive function

  • Confusion

  • Hallucinations

  • Lethargy

  • Difficulty concentrating

  • Memory loss

  • Delusions

  • Agitation

  • Aggressive behavior

  • Decreased appetite

  • Frequent falls

While it is crucial to be aware of the mental symptoms and behavioral warning signs of a UTI in older adults, it is still important to know the classic physical symptoms of a UTI. These physical symptoms tend to be less common in older adults or are more suppressed but can still be present.

Common Physical Symptoms of a UTI in Older Adults

  • Frequent urination

  • Discomfort when urinating

  • Burning sensation when urinating

  • Pelvic or stomach pain

  • Fever

  • Chills

  • Abnormal urine odor

  • Dark, cloudy, or thick urine

  • Frequent touching of private areas

  • New or worsening incontinence

Serious Symptoms of a UTI

If someone you're caring for experiences these serious symptoms, it could be a sign that the infection has spread to the kidneys. Once the infection spreads to the kidneys, seeking medical help is important. An untreated UTI could cause serious kidney damage and further infection, leading to sepsis, a life-threatening complication of infection.

Get prompt medical attention if you notice these symptoms:

  • High fever

  • Back pain

  • Nausea

  • Vomiting

  • Difficulty waking your loved one up

  • Urine with a pink or red tinge

What Causes a UTI?

UTIs are most often caused by fecal bacteria that enter the urethra — the tube that allows urine to leave the body — and travel to the bladder.

Sexual intercourse and improper wiping after using the bathroom are two of the most common ways bacteria enter the urethra.

Other risk factors for developing a UTI as an older adult include:

  • Having a catheter (a tube inserted through the urethra to drain urine from the bladder)

  • Having diabetes

  • An enlarged prostate

  • For women, lower amounts of vaginal estrogen 

  • Incontinence and regular wearing of adult diapers

  • Dehydration

UTIs can also be caused by fungus in the bloodstream but are much less common, usually affecting people who are immunocompromised due to illness.

How to Prevent UTIs in Older Adults

Luckily, there are a few simple things that older adults and their caregivers can do to prevent UTIs. Keeping up with these habits can go a long way in keeping UTIs at bay.

  • Wipe from front to back after toileting: This ensures you’re moving bacteria away from the urethra.

  • Stay hydrated: Older adults are prone to dehydration. If you’re a caregiver, offer frequent water or unsweetened drinks throughout the day. Also, consider providing your loved one with a reusable water bottle they can keep near them.

  • Practice good hygiene: This a simple tip, but it is always important! Make sure loved ones and caregivers wash their hands thoroughly for at least 20 seconds after going to the bathroom and bathe regularly. 

  • Don’t hold it in urine: Empty the bladder as soon as you feel like you have to pee.

  • Change incontinence wear frequently: Change adult diapers as soon as they’re soiled and thoroughly wash the body after leaks or accidents.

  • Practice safe sex: Wearing condoms during sex and urinating after sex to flush out bacteria that may have been passed during intercourse.

How to Treat a UTI

A UTI is diagnosed after a test is done on a urine sample. It will then be treated with antibiotics. If you suspect a UTI, go to the doctor as soon as possible so you’re loved one can be tested and treated. Quick treatment will prevent the infection from spreading and causing more serious problems, like kidney damage. 

Have More Questions?

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Call (800) 696-CARE, email support@carewell.com, or click the live chat feature at the bottom of the page. We are passionate about serving caregivers and would love to help make your life easier!

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Sophie Bebeau
Sophie Bebeau

Sophie Bebeau is a writer, graphic designer, poet, and multidisciplinary artist living in Green Bay, Wisconsin. When she’s not writing or making things for the internet, she can be found cross-stitching, writing poetry, and snuggling on the couch with a cup of tea and her husband, son, and dog, Buttercup.