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Urinary tract infection in very old women is associated with delirium

Published online by Cambridge University Press:  18 August 2010

Irene Eriksson ,
Yngve Gustafson ,
Lisbeth Fagerström  and
Birgitta Olofsson
Irene Eriksson*
Affiliation:
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden School of Life Sciences, University of Skövde, Skövde, Sweden
Yngve Gustafson
Affiliation:
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden
Lisbeth Fagerström
Affiliation:
School of Life Sciences, University of Skövde, Skövde, Sweden Department of Health and Life Sciences, University of Buskerud, Kongsberg, Norway
Birgitta Olofsson
Affiliation:
Department of Community Medicine and Rehabilitation, Geriatric Medicine, Umeå University, Umeå, Sweden Department of Nursing, Umeå University, Umeå, Sweden
*
Correspondence should be addressed to: I. Eriksson, School of Life Sciences, University of Skövde, SE-541 28 Skövde, Sweden. Phone: +46 500 44 84 75; Fax: +46 500 44 84 99. Email: [email protected].
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Abstract

Background: The aim of the study was to investigate whether urinary tract infection (UTI) in a representative sample of 85-, 90- and ≥95-year-old women is associated with delirium.

Methods: In 504 out of 643 women (78.4%) it was possible to evaluate UTI and delirium. Assessments such as the Organic Brain Syndrome (OBS) Scale, the Geriatric Depression Scale-15 (GDS-15) and the Mini-mental State Examination (MMSE) were performed during home visits. Delirium, dementia and depression were diagnosed according to the DSM-IV criteria. A diagnosed, symptomatic UTI with or without ongoing treatment, documented in medical records or detected in association with the assessments, was registered.

Results: Eighty-seven of 504 women (17.2%), were diagnosed as having a UTI with or without ongoing treatment when they were assessed, and almost half of them (44.8%) were diagnosed to be delirious or having had episodes of delirium during the past month. One hundred and thirty-seven of the 504 women (27.2%) were delirious or had had episodes of delirium during the past month and 39 (28.5%) of them were diagnosed to have a UTI. In a multivariate logistic regression model, delirium was significantly associated with Alzheimer's disease (OR = 5.8), multi-infarct dementia (OR = 5.4), depression (OR = 3.1), heart failure (OR = 2.3) and urinary tract infection (OR = 1.9).

Conclusions: A large proportion of very old women with UTI suffered from delirium which might indicate that UTI is a common cause of delirium. There should be more focus on detecting, preventing and treating UTI to avoid unnecessary suffering among old women.

Keywords

urinary tract infectiondeliriumold women
Type
Research Article
Information
International Psychogeriatrics , Volume 23 , Issue 3 , April 2011 , pp. 496 - 502
Copyright
Copyright © International Psychogeriatric Association 2010

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