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Dear doctor: Our 92-year-old mother, who is still strong as a turning point, was fine for a moment and then suddenly became weak and extremely disoriented. It was as if she had dementia. We expected to learn that she had suffered a stroke, but tests done at the hospital showed that she had a urinary tract infection. Why would it affect him? And why has she never had any other symptoms?
Dear reader: A urinary tract infection, or urinary tract infection, often occurs differently in older people than in younger people. Typical symptoms that we know – that include a burning sensation during urination; insufficient urinary flow despite a frequent need to go there; a cloudy, dark or odd urine; and pressure or pain in the abdomen – often does not show up. Instead, the first sign that a senior has a UTI can often be what you have described – a sudden change in his well-being and behavior. These infections can lead to serious problems, such as kidney damage or even sepsis, so that "silent" urinary tract infections pose a real threat to the health of the elderly.
A urinary tract infection occurs when part of the urinary system, including the urethra, bladder, ureters and kidneys, becomes infected with a bacterium. The urethra is the channel through which urine flows from the bladder and body. The ureters are the channels that carry urine from the kidneys to the bladder. Since the urethra is shorter in women than in men and is located too close to the rectum, a potential source of bacteria, urinary tract infections tend to be more common in women than in men. men.
It is possible that older adults often do not produce obvious symptoms because the physical changes that signal a urinary infection result from the immune system's fight against the infection. As we get older, our immune system tends to slow down, so that an infection may be more advanced at the time of onset of symptoms.
The first symptom observed by some older people is lower back pain, which occurs when the infection has reached the kidneys. In postmenopausal women, changes in the urinary tract can make them more vulnerable to infections. In men, prostate problems can result in incomplete emptying of the bladder, making them vulnerable to infection. As for the reasons why urinary tract infections are associated with altered mental status in the elderly, the reasons are not entirely clear. One theory is that the outbreak of inflammation, which can affect the neurotransmitters that help nerve cells to communicate, interferes with the normal functioning of the brain.
A urine test may reveal the presence of certain compounds in the urine that suggest a urinary tract infection. A urine culture will identify the specific bacterial cause. The good news is that UTIs respond well to antibiotics. As with all antibiotic therapies, it is essential to follow the entire prescribed treatment. In patients whose UTI had no symptoms, we also think that it is a good idea to consider monitoring the urine culture a few days after the end of antibiotic treatment. This will confirm that the UTI is completely cleared up.
Eve Glazier, M.D., MBA, is an internist and associate professor of medicine at UCLA Health. Elizabeth Ko, M.D., is an internist and assistant professor of medicine at UCLA Health.
Send your questions to [email protected], or write: Ask the Physicians, c / o Media Relations, UCLA Health, 924 Westwood Blvd., Suite 350, Los Angeles, CA, 90095. Due to the volume mail, personal responses can not be provided.
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