Dementia: The sign when going to the loo that may signal advancing decline – 'troublesome'

Dementia describes a host of symptoms relating to the degeneration of the brain, that worsen progressively over time. Some of the functions to deteriorate relate to memory and cognition. As the disease advances, however, symptoms may become apparent when going to the toilet.

According to the health platform Pathways Health, urinary tract infections are common among elderly patients.

The Alzheimer’s Association confirms this, stating: “It is common for people with dementia to get a urinary tract infection, particularly during the later stages of dementia.”

Four-smelling urine is often an indication that an infection is developing inside the urinary tract.

Pee may alternatively smell of ammonia, according to the Cleveland Clinic, which also suggests there is bacteria swimming inside the urethra kidney of the bladder.

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One potential explanation for the prevalence of UTIs among dementia patients is the deterioration of immune functions.

“It is thought that because our immune systems are altered as we get older, they respond differently to such infections,” explains Pathways Health.

“So, rather than pain symptoms, elderly people with UTIs may start acting more erratically and troublesome than usual.”


The Alzheimer’s association echoes this statement, breaking down some potential behavioural changes.

The majority of patients with UTIs tend to complain of physical discomforts, such as burning while urinating.

Senior patients, however, may instead behave erratically, offering clues to the state of their cognitive health.

What’s more, these symptoms may precede other telltale signs of dementia, which could help lead to an early diagnosis.

“It is also important to be aware that any infection could speed up the progression of dementia and so all infections should be identified and treated quickly,” explains the Alzheimer’s Society.

Indeed, when bacteria enter the bloodstream, they cause low-grade inflammation inside the body.

To avoid such risks, the health platform recommends drinking between six to eight glasses of fluid a day.

Urine should never be held in the bladder for too long either, so patients with dementia should be prompted to go to the toilet where possible.

Although UTIs are more likely to occur in the advanced stages of dementia, changes in urine odour may occur years before the onset of symptoms. These, however, may not be noticeable to the human nose.

In a study conducted by the Monell Centre, the US Department of Agriculture alongside other collaborating institutions, in 2016, researchers found alterations in urine correlated with changes in the brain.

More specifically, the study provided evidence that urinary order signatures could be altered by changes in the brain caused by Alzheimer’s’ disease.

The findings offered hope that physicians may be able to diagnose the disorder before the onset of brain decline.