UTI or dementia?

Dear Pepsee,

I'm very sorry to hear about the loss of your sister-in-law. I can imagine its been very hard on your mom and the whole family.

From what I understand it could be a UTI, but my other concerns would be side effects of any new or existing medications? Everyone reacts to medications so differently. It could be that grief coupled with the diabetes could be the bulk of it, but maybe there could be something else. High blood pressure, high cholesterol, undiagnosed vascular dementia. I hope the blood work and talking to the grief therapist will shed some light.

My mother had a UTI while she had dementia. It made several of her dementia symptoms much worse. She was very confused. But she wound up in the ER within a week of the symptoms starting. I can't imagine how it could go on for months!

I recently had a UTI. I am not cognitively impaired, but I sure felt like it then. Brain fog, confusion, slow to comprehend what was being said to me, falls several times a day, auditory hallucinations. The culture for a UTI takes a few days. I did not drive during this period. I had an e-coli infection, and when it cleared up so did the symptoms!

It sounds like you are doing a great job getting to the bottom of this, and rescuing mom. I hope it is something that can be cured quickly. And if it isn't, your mom is certainly lucky to have you looking after her!

One other thought. After my husband died I expected to feel sad, perhaps to cry easily, to be emotional. Instead I became very forgetful and confused. I tried to pay for my groceries with my library card, for example. I was seeing a psychiatrist and a psychologist for different issues at that time and both of them assured me I was not permanently cognitively impaired. Having cognitive problems as part of mourning is not typical, but it does happen and it is as normal as any kind mourning. I am glad you have included grief counseling on your list of ways to help Mom. Is is indeed lucky to have you.

I am 60 and I don't have any physical ailments. We had a tragic loss in the family last year, also involving small children half orphaned, and I found myself doing things I had never done before, like forgetting a friend's mother was dead, locking my keys in the trunk and leaving the water on in the kitchen with the sink stopper in. (What a mess!) It went on for months and my husband was getting very concerned about me. If you combine grief with untreated diabetes and what sounds like depression (matted hair, dirty) you might mistake it for dementia.

Sounds like you are doing everything you can do. I agree with the caveat that medications...especially psych meds...can cause unusual side effects. If your mom is elderly, it might be good to have a geriatrician or geriatric psychiatrist overseeing her medications.

Yes UTIs can case bizarre behavior. While you’re waiting on doctor appts give her a home AZO UTI test. They’re not 100% accurate but can give you an indication if she has a UTI along with the other issues. If positive I would recommend calling the Dr immediately for a office test.

Thank you so much for your kind words, and sharing your experiences. I gave my mom and Azo UTI test today and it did come up positive. I called the PCP and she will see her tomorrow for a urine test.

Mom is only 72, a fantastic person and a wonderful mother. I'm hoping for the best. She has since stop crying and freaking out, and now she's starting to enjoy my animals. I have three cats a dog and my neighbor's white duck comes over every day for a visit. LOL. Whatever makes her smile. 

Yes I will definitely get her into a  geriatric physicians care. I would feel much better if someone were overseeing her meds especially now that anti-depressants and anti-anxiety meds have been added. Thanks again!

There are two separate and interacting influences on your mother's health. The lack of good control of her diabetes, and presence of an infection can cause delirium which is a fluctuating confusion. This is also happening on top of depression which can present as a dementia. There is something called Pseudodementia. It is very important for her to be evaluated by a PCP and perhaps, a geriatric psychiatrist if her delirium does not resolve after treatment for the UTI. Being a diabetic makes her more susceptible to infections so control of this is important. You are doing a great job with your care. IT is critical to get her back on track with medications. Also, it takes time for depression to resolve so be patient and continue to support her and seek support for yourself.

It does sound like a sudden onset of a major depression. The others, UTI and diabetes, may add to it, but depression stands out the most. Has she been started on an anti-depressant?

Yes Myownlife, she is on Lexapro 10 mg. I have been giving her her diabetes medication as prescribed. Yet she still has readings of 262-310, 2 hours after meals. I told the doctor this over the phone, and she said after the UTI is cleared up we will see if the numbers go down. If not something has to be added to her medication for her sugar.

Depression is definitely lifting, I'm seeing a light at the end of the tunnel. :) Thank you to everybody for commenting, you don't know how good it is to feel I can reach out and talk to people about this. God bless

Cdn, Jeanne, Rocket, Marcia, Karen & Myownlife....😇💞💖.,.. Big Hugs for taking the time 4 us!

UTI has severe symptoms with elderly. It shows signs of frustration, hallucinations, extreme memory loss, sleep destruction, anger, and confusion. When you said that she's wearing the same clothes and her hair is a mess I would assume she is not showering well or cleaning herself well enough when she goes to the bathroom. A UTI going undetected for a long time can also cause death. I suggest every time you take her to the doctor have them check for UTI and also go to the drugstore and you can buy UTI strips to test at home. I go through UTIs with my mother all the time. When she has one it's like night and day.

Pepsee, I feel for you! First, and I’m sure others have already said this, it sounds like your mom has already been diagnosed with depression. From your description of her symptoms, I’d agree that’s very likely. The lack of hygiene could have resulted in a UTI as well, and yes, a UTI can cause some dementia-like memory loss and behavioral issues. Depression can also be associated with anxiety and anxiety can cause forgetfulness, basically the mind is so busy with anxious thought that it’s too preoccupied to keep track of other things as well. It sounds like your mom was your SIL’s main caregiver while she was very ill. That can be a cause of trauma also. It sounds like you are doing all the right things. If it doesn’t turn out that she has a UTI, I would suggest getting a referral to a neuro-psychologist for an evaluation. They can test her memory and give you a more specific memory loss diagnosis. Best of luck and bless you for taking her into your home. Make sure you take care of yourself while all this is going on. Eat right, keep exercising if you do or start if you don’t, and seek counseling. It’s very easy to lose ourselves in caregiving and you don’t want to go down the road of illness that self-neglect can cause.

It sounds like you're on the way to the correct diagnoses for your mom. My MIL who lives in a continuing care retirement community had a UTI awhile back and it caused bizarre behavior. She called us and told us the people from the TV were talking to her. We immediately called the nurse and had her tested for a UTI. It was positive and once they started her on antibiotics, she was fine.

My friend, couldn't keep still, swearing at every nurse there, hitting her husband, going in to other patience rooms and taking things. All of a sudden she was tested and she had a very bad UTI. Why don't the doctor's and nurses check this first. My friend has passed but the memories are all good.....

Yes, I have experienced this with my mom. When she has a UTI, her symptoms are exacerbated. Have her tested. Tell them you want a bacterial and fungal test performed. My mom had a UTI for four months. The doctor kept giving her antibiotics for a bacterial infection, but the UTI did not go away. Finally, we discovered that she had a fungal UTI. Fungal UTI's are not common, but do occur. If your mom tests positive for a UTI, and it seems to "reoccur" quickly, tell them you want a fungal test performed. Once the UTI is cleared up, she is back to her normal self. Also, see if you can get her a physician who specializes in geriatric. A geriatric specialist would have asked for a UTI test because they know how common they are. You can go on the Medicare website and search for a physician who specializes in geriatric to locate one in your area. There are not a lot of them because the pay isn't as good as other specialties, but if you can find one in your area, it will be such a big help. They understand what is happening with the elderly. Good luck.

I just went through this with my mom. She took a very sudden, drastic downturn, crying uncontrollably and dementia worsened significantly. I was actually thinking that it might be the end nearing. ER visit showed UTI. A round of Cipro and putting her on a very mild dose of anti depressant has brought her back to where she was before, thank goodness. So yes, it can drastically alter their mood and cognitive function. Good luck and hugs to you on your journey.

You need to get her diabetes under control.

Alzheimers disease or dementia is sometimes referred to by medical pros and type 3 diabetes.

Blood sugar issues can definitely mess with her mind.

Also, yes a UTI or any infection can cause hallucinations and other brain issues. That is not dementia, it is just a side effect of an untreated infection.

Also, sometimes the medications themselves used to fight depression can have some crazy side effects.

There are natural ways to fight depression......exercise is a major one, doing fun things together, taking her outside her own head by helping someone else, sometimes helps.

Oh Yes! and they may not be showing regular symptoms! No burning, No urgency! my clue was the strong odor of her urine. UTI can cause LOTS of problems with the elderly, especially with cognitive thinking. AND not all doctors realize this. It is not something that they generally look for so they just chalk everything up to the dementia. It takes the caregivers to point it out and DEMAND a urine test!! Good Luck!

Yes, an untreated UTI can have dementia like symptoms

You are doing a wonderful job of taking care of your Mom. it sounds as though she is on the upward path now and will contiue to improve.
One thing to remember is that antidepressants do take time to get up to speed. It usually takes at least a couple of weeks to see full results.
The UTI is treated and she is again showing interest in life around her.
My first though was also that your SIL's death and the lead up to it had thrown her into a tail spin and everything finally caught up with her.
Once she is stabilized she will probably be abe to go home and resume her former life if she so desires. Don't wait too long to address the need for more aggressive treatment of the diabetes. It all sounds as though it will be good from here in. I am sure she will be upset again when she reconnects with the deceased family so ease her into that gradually.

I agree with all the great advice that has been given here. My mom is on her fourth UTI since the first of the year. I did not know about fungal UTIs -- I will have to have her checked for that. The UTIs do affect her dementia incredibly. I assume that the AZO test does not assess that??? I also like the suggestion of a geriatric physician. I have tried and tried to find one in Mom's area, but no luck. They all go to communities, but my mom's AL community seems to be the one that does not have a geriatric physician who comes in. I thought I check that out before moving her there, but I might have slipped up on that because I was SO happy to find a community to which she would finally agree to move. Every doctor whom I'm told specializes in geriatrics is either just retiring or doesn't actually specialize in geriatrics when I call. I'm four states away with no help in this regard from sibs. The only one I could find who was actually taking patients was with a "MD VIP Concierge" group. There was an annual fee of $1,650 apart from any copays for visits, etc. Can't afford that, with $5500 a month for the AL community and another $500 for meds, depends, thickened juices, etc. Any advice on how to find a geriatric physician? thanks!

Yes, I have constantly!!! What has happened in the past is her Dr would prescribe an antibiotic and after that course is through after about 1 month her dementia symptoms would be back...we just cannot cure her UTI so I live with it. When I notice her dementia symptoms are so bad, back to the antibiotic again. We space this out because we do not want her antibiotic resistant. I’ve been told about something else that is supposed to cure everything and it is FDA approved and it is herbs etc.. I have mom on that now, today’s administration would be the 3rd day she’s tried this, so I can’t say this works or not. Other people on here have advised of things and I thought I saved it on Amazon and I see it is not there. You might want to do a search on this site and maybe you can find the products the people have tried and stated they have worked.

It's a good thing your mom has you. Sounds like you are on the right track. Make sure she is staying hydrated and good nutrition.
Dehydration can also give dementia type symptoms.

My mom is 93 and has chronic UTI’s. Drs put her on Keflex
500 ml but after 5 days of being off it the UTI returns. She is definately being treated with the right medication as the sample is always being sent to the lab.
UTI’s affect the elderly horrible! It can cause terrible shaking and more severe memory loss

Another thing...
My mom 93 has a geriatric specialist she goes to. After many UTI’s he gave me a referral to a Urologist. She has chronic UTI’s and his nurse gives us extra sterile jars to bring home as she finds it hard to “pee on command” at the office.
I can take her in without making an office visit with a urine sample and within 15 minutes they test it and let me know. It still has to be sent to the lab but at least they get her on an antibiotic. There was only one occasion that they put her on cipro and when they got the results from the lab they put her on Keflex 500 right away.

Thank you all so much for all your help. She's been started on antibiotics for the UTI. The depression is lifting which is great. Her memory seems to be getting better. I still don't see her being able to take her daily meds, or check her sugar by herself yet. Her biggest problem now is not being in her own apartment. Hopefully this will pass.

I decorated her room in all lavenders, white and soft pink, this has been fun since I never had a daughter just three sons. LOL!

It is possible your mom has the very early stage of dementia, but a UTI seems to bring on dementia-like symptoms sometimes in the elderly who do NOT have dementia. Where she seems better but is having difficulty remembering to take her diabetes meds and/or test, those could be warning signs that dementia is starting, but it would only be in the early stages, more manageable and mom could stay in her own place, so long as she has oversight for her meds (and checking to be sure she's caring for herself and the UTI is not back.)

I would only suggest that after you are SURE the UTI is gone, try weaning off or eliminating the anti-depressants or anti-anxiety meds and see if the symptoms return. If they don't, most likely this was UTI driven (of course stress and grief do not help!)

Before dementia set in for our mother (she *could* have been in the very earliest beginning, but I believe it was before memory losses started), being OVER-hydrated was an issue. Having been told she had interstitial cystitis, she was instructed to eliminate certain foods, eat some specific ones, etc etc. I stopped by one day on the way to work because I called and she seemed out of it. I had to take her to ER - she was drinking TOO MANY fluids (all dating back to that 'drink eight 8oz glasses/day', which is wrong!) and her potassium (and possibly other minerals) was all messed up!!! You CAN drink too many fluids, and it waters down all the "salts" (electrolytes) in your system - same issue with excessive diarrhea/vomiting, but that is exacerbated by fluid loss too. Potassium being too low caused her confusion, befuddlement. Once IV treated, she was back to her nasty old self!

Anyway, with dementia that UTI is a bear! Mom was in meltdown every night, wanting out, had to go home, had guests coming - went on for hours before they finally calmed her down. Of course it was a Friday, so we could not get meds or test until Monday! Even before that happened I suspected UTI and she already had appt for Monday, so I added a request for that test while we were there. Yup. So later, when we visited this Thursday afternoon, the aide told me she was in a funk again Wed night. I called again on Friday to check on this (I had to twist doc's arm to get anti-anxiety to have on hand - we do not dose unless it is needed and it WAS needed - only one at night if she's "at it"!) They said she was at it again on Thursday night and she was in that mode when I on the phone with them.

I checked on the dates - she finished that antibiotic on the 1st (it took almost the full week to eliminate the "sun-downing" issues) and starting on the 9th we start up again. I suspect the meds did not fully work and she still has UTI (given a week to build up again!). So I plan to home test her this weekend and if positive, call the doc on Monday.

I don't recall who said it about not keeping mom on antibiotic medications all the time to avoid resistance - it is actually WORSE to do it that way. The bacteria that survived the treatment for a week are the ones that are stronger and cause the reccurence shortly after treatment, begetting stronger offspring as well. I was told years ago by a urologist that if a UTI doesn't clear up with a few rounds, say two, of antibiotics, then it should be continuous for like 6 months and possibly longer!

So, yes, UTIs in the elderly (mostly) can present as dementia, but it really isn't. Yes, UTIs can recur or not get treated with one or two rounds. Usually full lab testing is best because some meds work better on different strains of bacteria - best to get the right meds the first time!!

UPDATE: since treating mom's UTI, her memory has gotten so much better. However I don't see her being able to manage her meds alone. She usually forgets what each pill is for and when to take it. I do see Dementia in the early stages. Will get her check for it. Mom fell yesterday what a horrible experience! She bent down to pick something up in the yard and fell backwards against the brick wall. She didn't really get hurt, she was more concerned with being a burden to us. Poor thing.

Depression and grief has gotten so much better. I talk to her daily about my sister-in-law, trying to make that subject not carry so much pain when she thinks about her. She has a locket around her neck that she carries some of sister-in-laws ashes in. She holds the lockit and talks to it at certain times. She's definitely coming to terms with the death and she's able to not grieve so much.

Her sense of humor is definitely back. She sits and watches some crazy talk shows with my son who is 20, and very attentive. They laugh and carry on! She's gotten much better with living with me, which, in the beginning, drove her crazy to know she was never going home.

Her hygiene is great, as a matter of fact, we're going for pedicures and manicures today! The bubble baths are out because I don't want to cause any more UTIs. But she does take a sit-down shower with a shower chair. I'll be coloring her hair Saturday. We just got her a haircut.

We bought her a bunch of new clothes that she really likes. She's really getting back to her old self.

This site is amazing! You guys have no idea the good you do and help you give! Thank you for caring and extending so much love and encouragement!💜

Hey Pepsee!

I use to be a regular poster here but have backed off recently to see if it helps to lessen my obsessing on my mother - the whole ball of wax from my childhood through her dementia and finally her passing. So - anyhoo...

I am so happy for you - to have read your update and that your mother is doing better. Still, I thought I’d share my first experience with a elder parents UTI:

Both my parents crashed physically at the same time. Mom was in the hospital and I had just put my father into rehab after an ER trip due to a prostate issue. Daddy wasn’t happy about it but accepted it as he knew he needed the medical care.

On my fathers second evening at the rehab he called me. Daddy was really agitated and was insisting that I come pick him up and take him home. I was a little baffled as just the day before he knew that was where he needed to be.

Then my dad started to talk about my driving to Corvallis, Oregon - my old college town from thirty years prior and a ninety minute drive from Portland, where I was - where HE was!

Seems my dad fully believe he was
in Corvallis, staying in my old sorority house - which had also been my moms sorority where he courted her, so he knew it well - and daddy thought all the nurses were my sorority sisters AND if I wasn’t freaked out enough - for added measure my dad seemed to think all the ladies were wearing skimpy lingerie!!! So - daddy being the solid, up-right kinda guy he was - he just felt the whole situation was inappropriate and I needed to come get him and take him home. NOW!!!

I called the rehab - after assuring my dad I would be there but it might take a while- they said they’d get him settled down and also get some urine to test. WTH??? I’d had a UTI once as a teen and I sure as heck didn’t have hallucinations!?!

No one bothered to tell me that a UTI
in the elder is a whole different deal. But sure enough - positive test -
antibiotics started and in 24
hours my dad was back to his usual self. Good thing too - as the staff caught my dad climbing out the window in his room that night.

After my fathers recovery and until the day he passed away, over a year later, my father remembered the incident. Daddy knew - rationally- that the situation never happened. But - my dad said that it still was so vivid to him he had a hard time accepting that it all never happened.

As for me, if I hadn’t experience it myself, I would have never believed it - what a UTI can do to the mind of the elderly.

WOW Rainmom! You know that's a testiment to show just how real the delusions are! After all,, we never get the chance to talk to dementia patients after the fact, in a right state of mind.

Yeah, I do think my mom is in the early stages though. I just came back from taking her to grab a coffee and a ride around. She was crying earlier for my sis in law. But that was the first time in two weeks. I told her to cry it out. She feels better now.

Thanks so much for taking the time to write me and for sharing your experiences.💚

Are you getting any help working through your feelings about your mom? It's got to be tough. I'm an ear if you need one.👂 ••• lol

Utifighter, thanks a million for the info!! I think we do need some pro active prevention!

Disgustedtoo, I agree I think the UTI made her worse but some form of dementia is starting. Thank you!