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Review
. 2022 Dec 8;14(12):e32321.
doi: 10.7759/cureus.32321. eCollection 2022 Dec.

Urinary Tract Infection Induced Delirium in Elderly Patients: A Systematic Review

Chandrani Dutta  1 , Khadija Pasha  2 , Salomi Paul  3 , Muhammad S Abbas  4 , Sondos T Nassar  5 , Tasniem Tasha  4 , Anjali Desai  4 , Anjana Bajgain  6 , Asna Ali  4 , Lubna Mohammed  4
Affiliations
Review

Urinary Tract Infection Induced Delirium in Elderly Patients: A Systematic Review

Chandrani Dutta et al. Cureus. .

Abstract

Urinary tract infection (UTI) is common in older adults, mainly due to several age-related risk factors. Symptoms of UTI are atypical in the elderly population, like hypotension, tachycardia, urinary incontinence, poor appetite, drowsiness, frequent falls, and delirium. UTI manifests more commonly and specifically for this age group as delirium or confusion in the absence of a fever. This systematic review aims to highlight the relationship between UTI and delirium in the elderly population by understanding the pathologies individually and collectively. A systematic review is conducted by searching PubMed with regular keywords and major Medical Subject Heading (MeSH) keywords, Science Direct, and Google Scholar. The inclusion criteria consisted of studies based on male and female human populations above the age of 65 in the English language, available in full text published between 2017 and 2022. However, the exclusion criteria were animal studies, clinical trials, literature published before 2017, and papers published in any other language except English. A total of 106 articles were identified, and nine final studies were selected after a quality assessment, following which a valid relationship between delirium and UTI was identified in this systematic review.

Keywords: asymptomatic bacteriuria; atypical presentation; delirium; elderly; geriatrics; infection induced delirium; urinary tract infection; urinary tract infection symptoms in elderly; urine infection.

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Conflict of interest statement

The authors have declared that no competing interests exist.

Figures

Figure 1
Figure 1. PRISMA 2020 flow diagram for new systematic reviews which included searches of databases and registers only
PRISMA: Preferred Reporting Items for Systematic Reviews and Meta-Analyses [10]
Figure 2
Figure 2. Atypical presentations of UTI in the elderly patients
UTI: urinary tract infection (Figure created by the first author)
Figure 3
Figure 3. Laboratory diagnosis tests for UTI
UTI: urinary tract infection (Figure created by the first author)
Figure 4
Figure 4. Examples of diagnostic tools for delirium
DSM-5: Diagnostic and Statistical Manual of Mental Disorders, 5th edition; ICD-10: The International Classification of Disease, 10th edition; 4AT: 4 'A's Test; CAM-ICU: Confusion Assessment Method for the ICU; ICDSC-Intensive Care Delirium Screening Checklist (Figure created by the first author)
See this image and copyright information in PMC

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