UTI Delirium in Nursing Homes

uti delirium

When you think of a urinary tract infection, you may not consider it a huge deal. However, the UTI symptoms and side effects can be life-threatening to older individuals experiencing a urinary tract infection. One of the UTI symptoms that generally affect the elderly community is delirium. In fact, UTI delirium affects millions of older adults every year.

When elderly patients don’t receive proper medical treatment promptly for their urinary tract infections, they could lead to sepsis and death. Sadly, elderly patients in nursing homes are even more at risk if they’re experiencing abuse and neglect at the hands of the medical staff. If an individual already has a pre-existing mental disorder like Alzheimer’s or dementia, they’re at a greater risk of experiencing UTI-induced delirium.

Unfortunately, the studies on UTIs and delirium have insufficient evidence explaining the effects in the elderly community. However, a recent study by researchers and scientists at Cedars-Sinai may have found a potential link between UTI delirium and a protein called interleukin-6 (IL-6).

If you believe your elderly family member is being abused in a nursing home, leading to severe UTI delirium, you have the right to pursue a lawsuit against the nursing home and those responsible. You could even file a wrongful death lawsuit if their infections led to the loss of life. Don’t let your loved one suffer in silence. Call San Antonio nursing home abuse attorneys at 210-366-4949 today.

What is a Urinary Tract Infection (UTI)?

A urinary tract infection, or UTI, is an infection that affects any area of the urinary system. This includes the bladder, urethra, kidneys, and ureters. However, most urinary tract infections happen in the lower area of the urinary tract in the bladder and urethra.

Urinary tract infections happen when bacteria enter the urinary tract through the urethra and spread into the bladder. Even though the urinary system is supposed to keep bacteria out, it sometimes fails. When the system fails, the bacteria can develop into an infection. If left untreated, the infection can travel into the ureters and kidneys. If the patient develops a kidney infection, it can have life-threatening consequences.

The most common bacteria that causes urinary tract infections is Escherichia coli (e-coli). The e-coli bacteria naturally live in the gastrointestinal tract of people and animals. Sometimes, e-coli can travel to the urethra from the lower intestine, causing an infection. Women, older adults, and those with weakened immune systems are at a greater risk of developing a UTI.

If you believe you have a urinary tract infection, it’s important to see your healthcare provider before the infection spreads to the ureters and kidneys. To diagnose your infection, your doctor will perform a urinalysis where they will look for the signs of a UTI. Your urine sample may also be tested for specific bacteria so your doctor knows how to treat your infection appropriately. Once diagnosed, your doctor will prescribe antibiotics for your UTI treatment and send you home.

delirium from uti

Common UTI Symptoms

Those suffering from a urinary tract infection (UTI) will experience inflammation along the lining of the urinary tract, which can cause problems urinating along with other uncomfortable symptoms. The most common UTI symptoms are:

  • Pain while urinating
  • Urinary retention
  • Bloody and/or cloudy urine
  • Pain in your lower back, flank, pelvic area, or abdomen
  • Pressure in the lower pelvic area
  • Urinary incontinence
  • Urinary urgency
  • Foul-smelling urine
  • Fever and chills
  • Severe lower back pain, nausea, and vomiting. This usually occurs when the UTI has spread to the kidneys.

Patients suffering from the symptoms above are experiencing what doctors refer to as a symptomatic UTI. However, older adults will commonly suffer from asymptomatic bacteriuria, which is a urinary tract infection that has no symptoms. According to the CDC, elderly patients with asymptomatic bacteriuria account for 25-50% of infections that occur in nursing home facilities. Those suffering from urinary tract infections without symptoms, especially the elderly, are at a higher risk of complications and hospitalizations. Older adults are more likely to develop sepsis when their urinary tract infections go untreated for an extended period of time.

Other UTI symptoms that are not as widely known include UTI delirium, agitation, acute confusion, and/or psychosis. Those more severe symptoms are more likely to occur in the elderly, especially if they already have neurological disorders like Alzheimer’s disease and dementia.

When the elderly experience UTI-induced delirium, it can result in sepsis. The consequences can be more dire if the patient has a history of frequent infections and antibiotic use. If the patient already suffers from cognitive impairment, they can be at risk of declining mental and cognitive functions caused by delirium. Older adults that frequently experience urinary tract infections and delirium are also at higher risk of death.

How Common Are Urinary Tract Infections in the U.S.?

Urinary tract infections accounted for 10.5 million doctor visits and two million emergency room visits in 2007. Women are more at risk for urinary tract infections since their urethras are shorter than men’s urethras. The shorter urethra allows for a shorter distance for harmful bacteria to travel, which can cause UTIs.

Women experiencing menopause are also likely to develop urinary tract infections due to their bodies producing less estrogen. As women age, their immune system also begins to weaken. Another risk factor for women developing UTIs is the use of certain types of birth control.

uti elderly delirium

Why Do Elderly People Have a Higher Risk of UTI’s?

The elderly community is at a greater risk of developing a UTI due to the following factors:

  • Estrogen deficiency in older women
  • Catheter and/or diaper use
  • A weakened immune system
  • An underlying disease like obesity, diabetes, bladder/kidney stones, functional abnormalities of the urinary system, etc.
  • Nursing home neglect or abuse – sitting in dirty diapers for hours on end, sexual abuse, poor hygiene, etc.
  • Malnutrition and dehydration

According to a 2014 study, urinary tract infections account for over one-third of all nursing home infections.

What is UTI Delirium?

UTI-induced delirium occurs in many elderly patients suffering from urinary tract infections. As people age, the brain is more susceptible to the adverse effects of inflammation and stress that the body produces when fighting an infection. The stress and inflammation that the brain is experiencing affect a patient by making them confused, aggressive, restless, or withdrawn; these are the symptoms of an individual experiencing delirium.

Over the past several decades, clinical trials have been conducted with elderly patients hospitalized and laboratory mice. During these clinical trials, scientific colleagues observed laboratory mice and how they were affected by UTI-induced delirium. A systematic review in 2014 stated that studies regarding UTI-associated delirium were flawed, leading to “biased results.” The study concluded that it was not conclusive in finding which urinary tract infections led to delirium.

Why Do Elderly People Experience UTI Delirium?

Anyone is susceptible to a urinary tract infection, but elderly people are at an increased risk. As people age, their chances of getting infections increase due to weakening immune systems. The risks of UTIs and other infections are higher in the elderly, especially when they use a catheter or wear diapers and live in a nursing home or assisted living facility. Bacteria like enterococci and staphylococci are also prevalent in nursing homes and assisted living environments.

Elderly patients experience different UTI symptoms due to their lowered immune system responses, making it more difficult to determine if they have a UTI. If the elderly patient also has pre-existing neurological disorders, like Alzheimer’s disease or dementia, they may not be able to tell hospital staff that they don’t feel well. This is why medical personnel must pay attention and look for common UTI symptoms in elderly patients.

Unfortunately, older adults are also at a higher risk of UTIs when they’re living in nursing homes or assisted living facilities that do not practice proper hygiene. When older people cannot care for themselves, they rely on others to do so. Infections can occur when the nursing and medical staff do not provide proper and clean care.

uti elderly confusion

The Link Between UTI Delirium and Interleukin 6 (IL-6)

A study conducted in 2021 found that interleukin 6 (IL-6) could become a significant player in UTI-induced delirium. IL-6 is a crucial protein that regulates the immune system’s response to infections.

Dr. Shouri Lahiri, the Director of the Neurosciences Critical Care Unit and Neurocritical Care Research at Cedars Sinai, and his colleagues observed laboratory mice to conduct this UTI delirium clinical trial. They monitored infected mice and uninfected mice in a variety of mazes. During their clinical assessment, they found that the uninfected mice tended to show fewer signs of memory loss and anxiety than the infected mice. Both memory loss and anxiety are two symptoms of UTI delirium.

Dr. Lahiri believes that the mice’s anxiety, brain dysfunction, and memory loss could be accredited to the presence of IL-6. Dr. Lahiri and his colleagues believe this due to a previous clinical study on the connection between delirium and ventilator-induced lung injury. Since IL-6 regulates immune response, Dr. Lahiri and his partners believe that UTIs and lung injury similarly react with IL-6. This helps explain the connection between delirium and the IL-6 protein.

During the clinical trial, Dr. Lahiri and his colleagues treated a few of the infected mice with an antibiotic that blocked IL-6 and its effects. The mice that were treated recovered from both their memory loss and anxiety. Their structural and functional brain functions were also completely restored.

Treatment for Urinary Tract Infections

Currently, the only treatment for UTIs is antibiotics. If someone has frequent urinary tract infections, they may have to take antibiotics often. When a person takes antibiotics frequently, this can lead to antibiotic resistance. Developing antibiotic resistance is dangerous, especially for elderly patients with lowered immune systems. When someone is prescribed antibiotics, the body creates a toxic environment to kill the harmful bacteria. However, with antibiotic resistance, the bacteria learn to adapt and survive in the toxic environment. The infection can often return after completing a round of antibiotics, but worse than before. More importantly, antibiotics do not treat UTI-induced delirium.

Dr. Lahiri believes the best solution lies in a clinical trial that uses anti-IL-6 antibodies to treat hospitalized elderly patients suffering from UTI delirium. Depending on how well the clinical trial goes, patients could recover from UTI delirium and live longer.

uti delirium in nursing homes

Call a San Antonio Nursing Home Abuse and Neglect Lawyer at Janicek Law Today

If you suspect that your elderly family member is suffering from a urinary tract infection or UTI delirium, you could have grounds for a nursing home abuse and neglect lawsuit. The nursing home abuse and neglect lawyers at Janicek Law are prepared to represent you and your loved one. Our legal team will fight for your loved one’s rights and make sure those responsible are held liable. To discuss your elderly family member’s case with one of our experienced attorneys, call 210-366-4949 today.


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