Detecting & Preventing UTIs in Alzheimer’s & Dementia Care

Katelyn Jordan
5 days ago
2 min read

Urinary tract infections (UTIs) may seem minor, but in people living with Alzheimer’s or other dementias, they can lead to sudden behavioral and cognitive changes — sometimes mistaken for disease progression. Early detection and prevention are key to protecting health and quality of life.

Why UTIs Matter for Alzheimer’s Care

UTIs are common among older adults and occur even more frequently in those with dementia.
People with cognitive impairment often cannot clearly express urinary symptoms such as pain, burning, or urgency.
Instead, a UTI may show up as sudden confusion, agitation, lethargy, or a drop in function — symptoms that can mirror or worsen dementia.
If left untreated, UTIs can escalate into kidney infection or sepsis, posing serious risks.

Recognizing the Signs

Here’s what caregivers and providers should watch for, especially when the usual symptoms are not obvious:

Traditional UTI Signs (when they occur):

Pain or burning while urinating
Frequent urge to urinate
Cloudy, dark, or foul-smelling urine
Blood in the urine
Pelvic or lower abdominal pain
Fever or chills

Atypical or “silent” signs (especially in dementia):

Sudden or worsening confusion
Increased agitation or restlessness
Fatigue, weakness, or lethargy
Changes in appetite or withdrawal
New or worsening incontinence
Falls, unsteadiness, or decline in mobility

If someone “just seems off” — not themselves — it’s often better to err on the side of testing for a UTI, rather than assuming behavioral symptoms are purely dementia-related.

Prevention Tips & Best Practices

Preventing UTIs is just as important as catching them early. Some effective strategies include:

Hydration: Encourage 6–8 glasses of fluid per day (unless medically limited). Frequent sips may work better than large amounts. If your loved one has a hard time drinking from a glass, a straw may encourage them to take bigger gulps.
Regular toileting: Prompt bathroom visits every few hours to avoid holding urine too long.
Good hygiene: Wash the genital area daily with gentle, fragrance-free soap; women should wipe “front to back.”
Manage constipation: Constipation can impair bladder emptying, increasing UTI risk.
Consider device use: Avoid catheters when possible; if used, follow strict infection control protocols.
Clothing and environment: Use breathable fabrics (e.g. cotton), change soiled garments promptly, ensure bathroom access is safe and visible

What to Do if You Suspect a UTI

Get medical attention quickly — a urine test (dipstick, urinalysis, and culture) is needed to confirm a UTI.
Treat promptly — antibiotics may be necessary.
Monitor behavior — many behavioral symptoms resolve once the infection is cleared.
Follow up — confirm that symptoms of confusion or decline have returned to baseline after treatment.