Dementia is a condition that affects your brain. It causes memory loss, personality changes, and – as the condition progresses –your body’s ability to function physically. Someone with advanced dementia may forget how to eat or drink, or may choke easily. This often results in malnutrition or infections like pneumonia. People with advanced dementia may be unable to move about on their own, staying in bed or in a wheelchair for extended periods. Poor nutrition and staying in one place for extended periods can cause skin breakdown, or pressure sores (also called bed sores).
These issues all result in an increased risk of contracting an infection. But people with dementia may have the additional problem of not being able to tell you there is something wrong if they do have an infection. For example, someone with dementia who has a urinary tract infection (UTI), may not tell you that he or she has pain when urinating. If the person is incontinent (urinates in a brief, has “accidents”, or has a urinary catheter), you may not notice if he or she is urinating more frequently. The first sign of anything being wrong may be an extreme change in personality or sudden worsening of the dementia. Urinary tract infections are one of the most common causes of sepsis, along with pneumonia.
Sometimes incorrectly called blood poisoning, sepsis is the body’s often deadly response to infection or injury. Sepsis kills and disables millions and requires early suspicion and rapid treatment for survival. Sepsis and septic shock can result from an infection anywhere in the body. Worldwide, one-third of people who develop sepsis die. Many who do survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, organ dysfunction (organs don’t work properly), and/or amputations.
There are an estimated 50 million people around the world who have some sort of dementia. Almost 6 million are in the U.S. The World Health Organization (WHO) estimates that there may be 82 million people world-wide with dementia by the year 2030. And by 2015, 152 million. Most cases of dementia, up to 70%, are caused by Alzheimer’s disease. However, there are other illnesses or conditions that cause dementia. Some are:
- Frontotemporal dementia (FTD)
- Vascular dementia
- Lewy Body dementia
- Posterior cortical atrophy (PCA dementia)
- Parkinson’s disease dementia
- Huntington’s disease dementia
- Creutzfeldt-Jakob disease
The effect of dementia on sepsis survival
Not a lot of research has been done yet on patients with dementia and their outcomes following sepsis. A study published in 2015 looked at patients with COPD who also had dementia. The researchers found that patients in this group had a higher risk of dying than patients with COPD who did not have dementia.
Can sepsis cause dementia?
Sepsis, specifically severe sepsis or septic shock, can worsen dementia or bring out into the open symptoms that weren’t obvious before the illness. Many people with early onset dementia manage quite well and those around them may not have realized there’s a problem until the infection and sepsis changed their daily routines.
A study published in 2017 looked at more than 20,000 patients with no history of dementia who were admitted to the hospital with sepsis for the first time. The researchers found that patients who had sepsis were more likely to develop signs of dementia after discharge. The researchers also found that younger age didn’t protect patients from developing dementia. In this study, some patients in their 20s were affected. And for all ages, the worse the sepsis, the greater the risk of developing dementia. Another study published in 2010 estimates that every year, there may be as many as 20,000 new cases of dementia caused by sepsis.
What caregivers can do
Caring for a loved one with dementia is challenging, but watching for signs of infections is important. Since people with dementia may not be able to tell you they are unwell or have pain, it can be hard to detect some types of infections. Here are some tips that may help:
- Signs of a fever. Not everyone with dementia will allow their caregiver to take their temperature. If you can’t check for fever that way, watch for other signs, such as the skin is warmer to touch than usual, flushing (red skin), lips or skin dryer than usual, or shivering even if it is warm.
- Increasing confusion or agitation, personality change, drowsiness . If there is a significant change in behavior, it could be a sign of an infection.
- Signs of pain or discomfort. If your loved one can’t say that something hurts or where there’s pain, body language may tell you. Some signs could include: protecting or guarding a part of the body, moaning or grimacing, eating less than usual, increasing restlessness, unwillingness to move, falling or having difficulty balancing, or crying.
- Coughing, wheezing, or shortness of breath. These signs could be caused by pneumonia.
Other things to keep in mind is if your loved one had an invasive procedure or hurt him or herself in some way:
- Are there any scrapes, burns, cuts, or bites on the skin?
- Did your loved one have a medical procedure, like having a urinary catheter, an intravenous (IV), dental work, or a procedure that broke the skin or inserted a medical device into the body?
- Has your loved one been exposed to someone who is or may be sick with a contagious illness like the flu?
- Has your loved one been hospitalized recently?
The only way to prevent sepsis is to prevent infection. The most effective way to reduce the spread of infection is through regular and thorough hand washing. Vaccinations for preventable diseases, such as influenza (the flu), shingles, and some types of pneumonia are also important. If there is an infection, early recognition and treatment can help reduce the risk of it triggering sepsis.
Not all cases of sepsis can be prevented. Sometimes infections aren’t detected and sometimes infections don’t respond well to treatments. In these cases, it is important to know what to watch for. The earlier sepsis is recognized and treated, the better the outcome. Think TIME for the most basic of symptoms. If your loved one is showing a combination of these symptoms, contact your doctor, go to the emergency room, or call 911, and say, “I suspect sepsis.”
To learn more about the different conditions that could increase your risk of developing sepsis, please visit the Sepsis and… library.
Would you like to share your story about sepsis or read about others who have had sepsis? Please visit Faces of Sepsis, where you will find hundreds of stories from survivors and tributes to those who died from sepsis.
If you suspect sepsis, call 9-1-1 or go to a hospital and tell your medical professional, “I AM CONCERNED ABOUT SEPSIS.”
Updated May 27, 2019.