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Urinary Tract Infections (UTIs) Cause Abnormal Behavioral Symptoms in Seniors

The link between your physical health and your mental health is undeniable. Certain conditions may cause mental or emotional symptoms before they create noticeable physical signs, so it’s important to be on the lookout for sudden changes in mood or personality in yourself or loved ones. In seniors, one of the most common examples of this physical and psychological link is urinary tract infections (UTIs). Although a UTI is a medical condition, it can lead to serious issues with confusion and agitation.

What Is a UTI?

A UTI is an infection in the urinary tract, which includes the kidneys, the bladder, the ureters, and the urethra. If bacteria enters the tract through the urethra, your immune system may or may not fight it off. The bacteria may persist and spread into your urinary tract, which leads to infection.
UTIs sometimes resolve on their own, but in certain cases, medical treatment is necessary to fully heal the infection. Treatment can always help to speed up the healing process and ease symptoms, too. Medical care for a UTI is especially important for older adults as seniors may have reduced immune functioning, so the infection may spread without resolving.

UTIs and Older Adults

Urinary tract infections affect people of all ages, and some are more susceptible than others. Women are more likely to develop UTIs than men because the urethra in a female body is shorter, but men can also be affected by UTIs. In both men and women, the risk increases with age, so a significant percentage of people over the age of 65 have experienced at least one infection.
There are a few possible explanations for this increased risk as you age. Older adults are more likely to experience weaker muscles in the bladder and pelvic floor, which can result in urine retention. When urine remains in the body, it becomes easier for bacteria to grow. Similarly, specific medical conditions, such as diabetes or enlarged prostate in men, can prevent complete bladder emptying.
Another possible cause of UTIs in aging adults is that the tissues lining the urethra and bladder can become thinner with age. This increases the risk of irritation and infection and may contribute to UTIs.
Hygiene can play a role in the development of a UTI as well. Although preventing an infection is not always entirely within your control, maintaining good hygiene with age can reduce your risk. Unfortunately, older adults sometimes struggle to keep up with hygiene if they’re affected by arthritis, dementia, or other health conditions.

Physical UTI Symptoms

In younger adults, UTIs typically present with physical symptoms. Older adults can experience the physical symptoms of UTI, too, but they may not be as prominent or as obvious. Seniors who have dementia or other conditions that affect their communication may also not be able to report their physical symptoms, which could lead to the UTI going unnoticed for a long time.
Here are the most common physical symptoms of a UTI:

  • Need to use the bathroom frequently
  • Incontinence
  • Pain or discomfort while urinating
  • Lower abdominal or pelvic pain
  • Dark or abnormal-smelling urine
  • Fever

UTIs can be a serious concern for older adults if the infection spreads to the kidneys. In this case, symptoms may include fever, chills, nausea, vomiting, or severe back pain.

Psychological UTI Symptoms

One key difference between UTIs in younger and older adults is that psychological symptoms are much more prominent in the elderly. Although the exact reason why is unclear, one research study identified a specific protein in the immune system that may affect the brain when activated by the infection. The following are the most common behavioral symptoms of a UTI in older adults:

Confusion, Hallucinations, or Delusions

Confusion or reduced awareness is very common among elderly adults who have a UTI, and this issue can be particularly common for seniors in nursing homes. You might have a hard time remembering where you are, or you might struggle to concentrate on your surroundings. In serious cases, hallucinations and delusions may be present, which can be extremely distressing for the individual and for those around them.

Agitation or Restlessness

Agitation and restlessness may occur in seniors with a UTI because of the physical discomfort, but these symptoms may also result from confusion or delirium. You may feel jumpy, nervous, or on-edge, or you might have a hard time falling asleep or staying asleep.


While some people feel intense agitation from a UTI, others feel very lethargic. Any sudden change in energy level could be cause for concern in an older adult. Fatigue and lethargy are symptoms of a wide variety of mental and physical disorders, but a lack of energy is common when your body is fighting off an infection.

Violent Behavior

Unfortunately, confusion or delusions could lead to violent behavior in some older adults. When you feel lost, disoriented, or agitated, you might lash out at those around you. Sometimes, elderly adults who have never had a history of violent behavior experience this issue when they have a UTI.

What to Do if You Suspect a UTI

The confusion and behavioral symptoms associated with a UTI are also symptoms of certain mental health disorders, so people sometimes think that their aging friend or relative is experiencing severe anxiety, depression, or psychosis. Because the physical symptoms of a UTI may not be as obvious for seniors, it can be difficult to narrow down the cause of the behavioral concerns.
You or your loved one’s primary care physician should be your first point of contact if you’re noticing unusual behavioral symptoms. Your doctor can perform tests to narrow down the issue, and they can refer you to a specialist if necessary. UTIs may not clear up on their own in seniors, so it’s important to reach out for medical support right away if you suspect one. The sooner you treat the problem, the sooner the physical and emotional symptoms will subside.
Blue Moon Senior Counseling provides mental health services for older adults. If you have any concerns about your or an aging loved one’s emotional well-being, you can contact us today to connect with a counselor in your area.

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