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I’ve always work in the medical field in my younger years. I switched gears in my Mid 40’s. Either I have forgotten, or it was never clearly explained, but why do yeast infections & UTI’s affect the mind so severely? My mother had both and to top it all off had allergic reactions to not just one medication but two more? My mother went into to a near a psychotic fit! Took her to the ER but it was like someone flipped the switch, and the posed demon disappeared! She suddenly became a sweet loving person! Who never ever revealed sweet loving kindness in her healthy life!

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"How does a UTI affect the brain?

You may be wondering how an infection in the urinary tract affects the brain? Scientists haven’t found the exact link between UTIs and delirium, but here’s what experts believe is happening.  

Any time we have an infection, our immune system kicks into gear to fight it off. During this process, our body releases chemicals that cause inflammation. These chemicals can also lead to many of the symptoms we feel, like fatigue or fevers. In older adults, the brain is more affected by the inflammation and the stress hormones that the body produces to fight the infection. The effects of this inflammation and stress on the brain are what show up as delirium.

So, why don’t young, healthy adults get delirium with infections like UTIs? This has to do with the blood-brain barrier, a special protection between the brain and the rest of the body. The blood-brain barrier keeps bacteria, viruses, and fungi that threaten the health of the brain from reaching it. This barrier isn’t as strong in older adults, so the inflammation from infection has a higher chance of affecting their brains. 

However, not all older adults with UTI get delirium, and not all people with delirium have a UTI. "

Source: https://www.goodrx.com/conditions/urinary-tract-infection/uti-and-confusion#

Also another article:
https://www.cedars-sinai.org/newsroom/unlocking-the-cause-of-uti-induced-delirium/
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https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9827929/

Short answer: Anything that impacts kidney function will impact the patient's metabolism. Metabolic changes are not well tolerated in frail persons, especially with dementia. Not all elderly have these symptoms.

"Delirium is a common atypical clinical presentation of UTI in the older population. Delirium can be precipitated by UTI, or UTI can occur due to impaired maintenance of personal hygiene as a result of delirium, leading to unfavorable outcomes. Therefore, there is a valid and complex relationship between them. However, there is no evidence of asymptomatic bacteriuria with delirium. In most cases, UTI-induced delirium is reversible. Various diagnostic tools are available for diagnosing UTIs but the presentations of the infection are often a source of clinical confusion.
This systematic review emphasizes the commonest presentation of UTI in older adults. The aim is to direct clinicians toward the atypical presentation of UTI to minimize the delay in identifying the underlying condition and initiation of treatment. We found that early antibiotic treatment is common in bacteriuria without symptoms of UTI. It is known to precipitate delirium therefore, the initiation of antibiotics should be delayed in asymptomatic patients until a confirmed diagnosis of UTI is established. We also found that there are various criteria of symptoms for the diagnosis of UTI found across different works of literature, which may cause overdiagnosis. Therefore, we recommend that various clinical presentations of UTI like delirium, tachycardia, and hypotension should be identified and studied to prevent delay in treatment. Furthermore, there are multiple explanations available for UTI-induced delirium, a well-designed study will help in clarifying the exact pathophysiology of UTI-induced delirium."
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Davenport Dec 8, 2023
Thank you so very much for your thoughtful and thorough response, Dr. Benshir!
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In all my years of elder caregiving, I'm going to say that it depends on the person's personality.

I've had many elderly clients with some kind of dementia who have had UTI's and didn't know they had one. They didn't go beserk and off the rails. No personality changes at all. Many times the only reason why a UTI was even suspected was because I would notice dark urine that had the smell. There's a different smell when there's a UTI. So the doctor would prescribe medication.

I find that elderly clients who had a more argumentative and ornery personality to begin with who were often agitated and angry were the ones who would really go off the deep end when they had a UTI.

I really think it depends on the person and what they're normal behaviors are like.
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VictorianDoll Dec 5, 2023
Thanks for your input! The UTI, was hard to detect via normal color/odor the first labs came back negative, she was given antibiotics, but then the yeast infection presented its self. I accidentally found a huge possibility as to how that started! Mom wasn’t throwing soiled TP in toilet to flush! She was placing it into her panties, every time. Not matter if urinating/ BM! 🤮 yuck! I now make sure I present during this time. Behavior yes I agree with you. Moms always had loud over barring behavior, hateful @times. She became heavy @one point in time 300# then she literally starved herself, to impress a young kid that manipulated her, she weight 85# now she’s rude, nasty to heavy set people! Yes my thoughts are some of her behavior is part of her personality!
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WebMD and other online sites will explain in some detail some of the reasoning behind the supposition that UTIs MAY cause some mental changes in the elderly. As you will know, the urinary system is very complex. As to yeast infections, while they may contribute to some depression and angst, they don't to anyone's knowledge that I know of, cause the mental changes that UTIs do.

Go to your favorite search engine and type in "causes of mental changes and UTI" and you will get lots of fun reading.
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ElizabethAR37 Dec 4, 2023
Although UTIs evidently can cause major changes in mental state, it's good to know that not all older adults experience these issues with a UTI. I've had 3-4 in the 6+ years since I turned 80, but they didn't affect my behavior or mental state (other than being distressed at a 2-3 day delay to get tested and treated. I didn't feel like waiting up to 10 hours in Urgent Care, especially during COVID, so that's on me).
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There’s a book called:
The yeast Connection..

weightcwatcher friend says:
Sugar, Wheat, and yeast are not your friends.

blood travels all over your body. urinary tract infection gets past the bladder and kidneys, that infectious waste is going to end up in blood stream. It’s going to travel to other organs and fog the brain, and make that person wonky minded.
I was threatened by my doctor if I didn’t stop.. I was going to have an insulin tube put directly into my pancreas.

yeast.. you are what you eat. I need to go back on my diet.. I went strictly to homemade chicken soup with plenty of vegetables, onion, garlic, hot peppers and spices. Trader Joe’s had the best mint tea. If you need to dissolve a craving, mint tea helped me.
snywsy, thinking if a lil nugget got past the kidneys, it’ll get into bloodstream..
wgen the body cannot process toxins, ammonia can buildup in blood stream. When it hits the brain, things get messy. And I am not a doctor or anything, so google it and webmd is good and a few other choices to look at.
snywsy, that is my understanding if UTI,
Do watch out for the teeth and bad dentures, this is why some dentists suggest going on an antibiotic before tooth cleaning, blood is blood, and infections or bacteria in mouth travel. Her dad was hit with an infection that affected the heart muscle.
He ended up in ER., and that’s how they found his problem.
Older people get UTIs so easily, perhaps not enough fluids, or excercise to get the blood circulating..
Look it up, and ask questions
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LadyDi6653 Dec 8, 2023
Does Splenda fall into the "sugar" category? 94 YO Mom goes through it like crazy.
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Older adults have a shorter window of physiologic stability. Any injury or infection will likely cause changes in mentation and / or in physical ability. Sometimes it may even be caused by constipation or a mild cold. Those changes were often our first clue to do a through check. Important to know the baseline and not just assume someone is confused or more confused because they are older.
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My mother-in-law gets very confused when she has a UTI, more than her normal dementia. My mother on the other hand never showed any signs, she ended up getting sepsis and died from one.
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AliBoBali Dec 8, 2023
Wow, Sherry. That's awful that there were no signs. I'm so sorry.

I can relate some because my dad became septic after his catheter was improperly inserted, and he showed no change in cognition or behavior.

I knew something was wrong with him, but it was only because there was no urine output in the catheter bag. He also wouldn't eat. But he was coherent as can be and refused to let me take him to the ER.

I called 911 to come to assess him and convince him to go to the ER, and he answered all the EMT's questions correctly and declined to go to the hospital.

Thankfully, I finally convinced him to go to the hospital in the next day or so, and they found he had full-blown sepsis -- and a temperature of 97F.

No confusion. No temperature. But he had acute sepsis.

It took several weeks of hospitalization and a month of rehab before he was back home with a new G-tube... which was able to be removed a few months later.

If it weren't for my having such an obvious measurement of some problem, i.e., the lack of urine in the bag, he would have died.

Just wanted to say that I've seen this, too, where sepsis doesn't affect thinking or behavior and doesn't cause a temperature or other detectable change. It's wild.

And I'm just so sorry that sepsis wasn't caught/treated in your mom's case. And I wonder what other tests or evaluations one can even do when behavior hasn't changed, and yet someone can be at that level of extremely sick.
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I was told "any" infection can cause confusion etc. in an older person. I have found this true with my husband who rarely has had a UTI but has other infections. Even if the infection does not cause the confusion the prescribed meds could, especially when added to other meds most older people already use.

A problem we had with my father was quite often he had "normal" confusion. Because we were there with him in the nursing home, we often saw the changes when his confusion elevated to a much higher level. We would ask the nurses to test him and it was often several days before they would do a test and by then the infection was much worse. They even sarcastically would say.... how can you tell because he is confused all the time! Because we were with him a lot more than the staff we would recognize the changes! Sure enough, every time it happened, the tests were positive.
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UTIs can cause sepsis - an infection that affects multiple major organs in the body. When the infective organism is killed by antibiotics and white blood cells, they spill their contents into the bloodstream - including toxins that can affect the mind. Yeast infections generally do not impact the brain but point to a weakened immune system. That weakness usually means that infections can take hold easily and create the same issues that sepsis does. Allergic reactions generally cause "swelling" of tissues in the body. Symptoms are linked the area(s) of the body that "swell" - heart (heart attack symptoms or cardiac arrest), respiratory tract (wheezing or stop breathing), neurological symptom (pain, numbness, or brain symptoms)...
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It is very strange how it happens, but I guess it just boils down to it’s an infection that travels and obviously crosses to the brain barrier. Infections are basically parasites. Most don’t believe or make that connection, but it’s a fact. If you look under a microscope at even tap water it will terrify you.

My mom has always been overbearing and controlling, but after her hip surgery she got dementia and became so mean and hateful. It is brutal being around her.

Then she started getting even worse and delusional. Had her checked numerous times for UTI’s. They always came back negative.

This last time teat came back positive for UTI. She was always stuffing toilet paper down her pants and I am assuming maybe some bacteria was coming from that and infection was finally caught. Her behavior settled down after getting antibiotics. She went from acting like she was demon possessed back to her normal critical and nasty behavior. I think when people get older less care is given and that really angers me. Dealing with a loved one with dementia is hard enough without adding other issues to the mix. We have to be their voice because they have no clue where they even are most of the time. I’m terrified of getting this brutal disease. Her disease has affected me so much that I’m actually physically sick myself just worrying and dealing with it.

Some get nicer, some get meaner with this disease. My mom is like dementia on crack. Accuses everyone of stealing from her and raping her on a daily basis. Then tells me God will make me suffer. It’s so awful. 😢
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MargieRKB Dec 8, 2023
From a microbiologist. The bacteria does not cross into the brain. That would make it meningitis, very serious. It might not cross into the blood (bacteremia) also very serious. The body chemistry can be affected and that is more likely the cause of the different behavior.
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