The Hidden Infection Masquerading as Dementia

Grandma's "senior moment" could have a more insidious reason...

Confusion... disorientation... forgetfulness... difficulty performing daily tasks... You might chalk those signs up to Grandma just having a senior moment or even early signs of dementia.

But sometimes, those sudden cognitive problems could actually stem from a reversible condition, one that has nothing to do with aging neurons.

The culprit?

A urinary tract infection ("UTI").

This incredibly common infection occurs when bacteria from stool or even skin get pushed into your urethra. Millions of Americans get UTIs each year.

Our female readers in particular are probably familiar with the signs... like seeing blood in the bowl and feeling a sting as you try to pee for what seems like the millionth time.

You've probably got the drill down pat... chugging fluids like there's no tomorrow and then popping over to your nearest outpatient-care center if you're still not feeling so hot or feeling worse after a couple of days.

But the older you get, the more likely it is you'll see completely different signs...

As emergency physician Erika Kube, M.D. mentioned in 2021 in the Columbus Dispatch, "Altered mental status is often the only symptom of a UTI in an elderly person. Behavior such as increased confusion, hallucinations, agitation, dizziness, falls and poor motor skills are often mistaken for early stages of dementia, but all can be caused by a UTI."

Also called delirium, this rapid worsening of the mental state is more common than you'd think. It's found in nearly 30% of older folks with UTIs.

A 2018 study estimated that infection triggers roughly half of all cases of delirium in seniors. As for the reason why, scientists suspect a UTI triggers inflammation that can disrupt how our neurons function.

And UTIs are the second-most-common type of infection in adults aged 65 and over at hospitals and community-living centers (with lung infections ranked No. 1).

Without proper treatment, the infection can spread from your bladder to your kidneys, permanently damaging them.

You could even end up with a blood infection. Called sepsis, it's a serious condition that can lead to multiple organ failure, amputation, and death. According to a 2020 U.K. study, UTIs beat out skin infections and respiratory-tract infections in raising sepsis risk – no matter the age.

To make matters worse, our risk of developing UTIs increases with age. And UTIs unfortunately have a habit of showing up in unexpected ways when you're older...

You can see just how tough it can be to catch and treat a sneaky UTI. But you can lessen the chances of getting this infection in a few simple ways...

1. Hydrate and don't hold it.

Researchers believe hydration alone can solve half of all UTI cases. How? Well, staying hydrated means you're diluting levels of problematic bacteria in your urinary tract and you're flushing the bacteria out with your urine.

As we get older, many of us might end up with urinary incontinence ("UI"), which means we can't control our bladders as well and end up with leaks.

If you're struggling with UI, you might be tempted to cut down on your fluid intake to prevent an accident. But cutting down too much can make you dehydrated, which can lead to a medley of problems – including UTIs...

Your urine becomes concentrated (it's why the color gets darker) and irritates the bladder walls.

You can end up with spasms and UI. Or worse, you could develop interstitial cystitis, where you have the urgent and intensely painful need to urinate.

Your urine volume decreases, and that means less fluid to push out bacteria from your body, putting you at risk of developing a UTI.

You can end up with kidney stones or even kidney failure.

When it comes to hydration, choose your form wisely... Go easy on caffeine and alcohol. Both are diuretics, meaning they increase the amount of water your kidneys remove.

On average, it takes older folks 33% longer than the young bucks to metabolize caffeine. So if you're fond of tea or coffee, that's fine – just try to limit caffeinated beverages to the mornings.

I love my morning cup (or two) of joe, but I make sure to stop my caffeine intake in the early afternoon. Cutting yourself off earlier means you're less likely to end up waking up and blearily stumbling to the bathroom to urinate, allowing you to log more hours of high-quality sleep.

2. Hygiene is key.

That means wiping front to back using clean toilet paper. Showering, rather than taking a bath, also helps cut the risk. And post-sex peeing is practical for flushing out any pesky bacteria that may have entered the urinary tract.

And finally, based on an interesting new study, keeping good food-hygiene practices helps, too...

Scientists compared E. coli bacteria from meat with E.coli bacteria from UTI-positive urine samples. The meat samples came from chicken, turkey, beef, and pork sold at Southern California supermarkets and the urine samples from UTI patients living in the same area, both collected over a four-year period.

Surprisingly, as the researchers found, foodborne bacteria accounted for 18% of UTI cases. And much of the contamination was in poultry products. So with the holidays just around the corner (including, of course, turkey day), make sure to wash your hands thoroughly in between handling raw meat, as well as cooking meat thoroughly (like poultry, to at least 165 degrees Fahrenheit) to kill off pathogenic bacteria.

P.S. Confusion from a simple infection isn't the only hidden – and misunderstood – health danger...

I recently dove into another stealth threat: fatty liver disease. It affects at least a third of Americans, most of whom probably don't even know they have this problem. I cleared up some misconceptions and myths about this disease in Retirement Millionaire. (Give my flagship newsletter a try for 30 days if you're not a subscriber yet.)

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Here's to our health, wealth, and a great retirement,

Dr. David Eifrig and the Health & Wealth Bulletin Research Team
October 28, 2025