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When my mom suddenly became confused, we suspected Alzheimer's. The truth, it turned out, was different: she had a UTI, and it nearly killed her.

My mother, about 77 at the time, someties got a little bit confused. She'd get dates wrong, for instance, or the names of nurses she didn't know well. She definitely didn't have dementia though. Then, one day, she asked why my dad's car wasn't in the driveway and whether he'd gone on a trip. My dad, her husband, had passed away about six years earlier. Was this the earliest sign of Alzheimer's? My sisters and I certainly thought so.

As it turns out, though, something completely different was the matter with my mother.

We called the family doctor — despite my mother's avid protests — and by the time he made a house call, my mother was also in bed with a fever. After tests, it became clear that she suffered from something that we have probably all encountered during our lifetimes: a urinary tract infection. As she had been incontinent for a while and used incontinence pads, she did not spot the "tell-tale" symptoms of frequent urination and a burning sensation in the urethra. My mother was promptly transported to hospital. Had I called the doctor a few days later, he said, she would have died.  

Why Older People Get More Urinary Tract Infections

Older people's immune systems are no longer as strong as those of their younger counterparts, making them more vulnerable to the bacteria that enter their urinary tract through the urethra, a process they are more vulnerable to because they often suffer from urinary and fecal incontinence or require urinary catheters for surgical interventions. Bladder prolapse, a condition in which the bladder can't empty as fully as before, also makes them more susceptible to UTIs.

A general lowered standard of hygiene, mobility problems, an increased risk of kidney stones, an increased likelihood of having a history of abdominal surgery, and diabetes all contribute to the risk of UTIs as well. Then, there are some sex-specific risk factors. Men who are senior citizens are more likely to have an enlarged prostate, while postmenopausal women no longer enjoy the protective benefits of estrogen. 

Symptoms Of Urinary Tract Infections In Older People

While younger people can often tell they have a UTI right away, because they will experience burning sensations in their urethra and feel the urge to urinate without being able to pass much urine, those symptoms can be completely absent in older people — especially those who are already in the beginning stages of dementia. 

I was, honestly, uttterly surprised when the doctor told me my mother had a UTI. Yet, the symptoms she displayed aren't unusual at all. 

UTI symptoms in senior citizens can include the symptoms you'd expect, but they can also involve:

  • Confusion, or a delirium-like state.
  • Hallucinations.
  • Becoming aggressive or agitated. Other behavioral changes may also take place.
  • Dizziness.
  • Falling.
  • A sudden deterioration in motor control skills.
Because these symptoms are all alarming, caregivers may not initially notice pink urine (containing blood), a low grade fever, and nightly sweats and chills. The person themselves may not be able to identify urinary urgency and burning sensations.
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