Bladder Infections and Delirium
A Common Cause of Newly Occurring Confusion is Cystitis
Jan 11, 2009
The urinary bladder clearly serves an important function. It functions to collect the urine being produced by the kidneys and store it until there is sufficient quantity to signal the need to go to the bathroom. The kidneys produce urine as a function of filtering waste compounds out of the bloodstream. The urine travels from the kidneys, down the tubes known as ureters, to the bladder. When enough urine has collected in the bladder, muscular contractions expel (void) the urine through the final tube, the urethra, to the outside of the body.
The Urinary Tract Is Normally Sterile
Under most common, everyday circumstances the entire system for producing, storing and expelling urine is free of any insulting organisms such as bacteria; that is the system is sterile. Not surprisingly, sometimes bacteria can enter the urinary tract and cause infection. This occurs much more frequently in women than in men because of the differences in anatomy and women having a much shorter urethra. This makes it easier for offending bacteria to travel up the urethra to the bladder.
Common, Non-Complicated Bladder Infections
The presence of bacteria in the urine and the bladder (a bladder infection or cystitis) gives quite well known symptoms for most people. There is an increased sense of urgency to urinate. Additionally, there may be an increased frequency of urination, sometimes with greatly reduced urine volume. There also may be a burning sensation when voiding.
Uncommon Symptoms Occur in the Elderly
In a healthy individual, a bladder infection routinely declares itself with some of the symptoms described above. Generally, a quick course of antibiotics can solve the problem. In the elderly population, especially the frail elderly, the onset of cystitis can cause additional symptoms and sometimes none of the routinely found ones. One of the more distressing symptoms is delirium, which can present as confusion or an acute alteration in behavior and understanding. This can also include the occurrence of hallucinations.
How Does Delirium Occur with Cystitis?
The simplest answer is that it is not known. Oftentimes, elderly people with a bladder infection may also be dehydrated, which can add to the difficulties. They may or may not have other generalized problems, some of which you might not associate with a bladder infection. Unfortunately, people living with dementia may be more susceptible to the occurrence of delirium with the presence of cystitis or any of a number of other “routine” infections.
It is important to understand how seemingly minor things for young, healthy individuals can cause very much major effects in the elderly. As always, speak with your healthcare professional for specific answers to your healthcare questions.
Read more about urinary tract infections at the US NIDDK.
Read this recent article on medscape to better understand the difference between dementia and delirium.
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