Parkinson’s psychosis and UTIs: Is there a connection?
Fact-checked by Parkinson’s disease can involve symptoms of psychosis, such as hallucinations and delusions, which often arise in advanced stages of the condition or as a side effect of Parkinson’s medications. If your loved one’s psychosis seems to have worsened, you may wonder what caused the change.
In some cases, what you are seeing may not be a worsening of the existing psychosis but symptoms of delirium — a sudden state of confusion that can be caused by urinary tract infections (UTIs) and other factors.
Delirium can involve hallucinations and other symptoms that overlap with those characterizing psychosis, making it challenging to distinguish between the two conditions.
Understanding the differences between psychosis and delirium and learning about the role of UTIs in the development of delirium can help you find the right care for your loved one.
Parkinson’s psychosis versus delirium
Parkinson’s psychosis and delirium share certain similarities, but they also have unique features that make them distinct.
Similarities between Parkinson’s psychosis and delirium include:
- Hallucinations: Both can involve seeing or hearing things that aren’t there.
- Delusions: Suspicion and false beliefs may occur.
- Behavioral changes: Agitation and unusual behavior may manifest.
- Disorganized thinking: Speech or ideas may seem difficult to follow.
Key differences of the two include:
- Onset: Parkinson’s psychosis develops gradually, over weeks to months, whereas delirium occurs suddenly, within hours to days.
- Course over time: Parkinson’s psychosis is stable or progresses slowly. Delirium tends to come and go throughout the day.
- Presence of confusion: Confusion is severe and central to delirium. With psychosis, individuals usually know where they are and who they are, which is not the case for delirium.
- Attention and awareness: Impaired attention is a core feature of delirium, whereas with psychosis, it usually remains unaffected.
- Cause: Parkinson’s psychosis is related to disease progression or medication, whereas delirium is triggered by a medical issue, such as a UTI, pneumonia, or electrolyte imbalances.
- Reversibility: Parkinson’s psychosis is chronic and progressive, whereas delirium can be reversed if its cause is treated.
- Treatment: Psychosis is usually treated through adjusting Parkinson’s medications and potentially prescribing antipsychotics. Delirium is treated primarily by addressing its underlying cause, whether it’s a UTI or another factor.
Ultimately, only a doctor can determine with certainty whether your loved one is experiencing symptoms of psychosis, delirium, or both. When you notice any concerning symptom changes, report them to a neurologist right away.
UTIs and delirium
UTIs are a common trigger of delirium, especially in older adults.
Scientists don’t know for sure how to explain the connection between UTIs and delirium, but they believe inflammation may play a role.
When the body fights a UTI, it releases inflammatory chemicals that can interfere with the function of brain cells. In a brain already compromised by Parkinson’s, this may lead to symptoms of delirium.
Signs of a possible UTI
With Parkinson’s, a UTI may not always cause typical urinary symptoms. The first signs can be changes in thinking or behavior, often indicating delirium.
These include:
- confusion or disorientation
- new or worsening hallucinations or delusions
- difficulty focusing or following conversations
- decreased alertness
- agitation and unusual behavior
Classic UTI symptoms may still occur, such as:
- a painful, burning feeling during urination
- urine with a strong smell
- urgent, persistent need to urinate
- frequent passing of small amounts of urine
Treatment and prevention
If your loved one is diagnosed with a UTI, a doctor can determine the best course of treatment.
Usually, UTIs are treated with antibiotics. In case of a severe infection, or one that affects the kidneys, the patient may be referred to a hospital for high-dose antibiotics administered intravenously.
There are ways to try to prevent UTIs. These include:
- drinking plenty of water to urinate more often and flush bacteria through the urinary tract before they multiply and cause infection
- contacting an occupational therapist to help your loved one safely navigate the way to the bathroom
- using the bathroom as often as needed
- consulting a physical therapist regarding pelvic floor exercises, which can help strengthen the muscles involved in urination
- tracking symptoms and notifying your loved one’s doctor about any concerning changes
- visiting a urologist, who may request a bladder scan to detect issues that may lead to UTIs
- inquiring about urodynamic testing, a diagnostic tool to evaluate how well your loved one’s bladder and urethra are working
With Parkinson’s disease, recognizing early warning signs and acting promptly can make a significant difference. Because delirium can often be reversed, timely treatment of underlying causes, such as UTIs, can help prevent potential complications.
Parkinson's News Today is strictly a news and information website about the disease. It does not provide medical advice, diagnosis, or treatment. This content is not intended to be a substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health provider with any questions you may have regarding a medical condition. Never disregard professional medical advice or delay in seeking it because of something you have read on this website.
