UTIs in older adults

Burning. Frequency. Urgency. If you’ve had the misfortune of dealing with a urinary tract infection (UTI), you’ll recognize these symptoms well. But while a UTI may be simple enough to detect and treat for most, it’s not always as easy to spot and manage in older adults.

A UTI can potentially lead to serious health issues, like a kidney infection or sepsis. It’s crucial for caregivers and family members of seniors to prevent UTIs and know what symptoms to look out for.

Why you’re more at risk as you age

UTIs are one of the most common infections experienced by older adults. In fact, studies have found that 10% of women over 65 report having a UTI within the past year — a number that increases to nearly 30% in women over 85.

“As we age, several factors make us more prone to UTIs,” explains Dr. Ashkan Abedini, a family medicine doctor with Sharp Rees-Stealy Medical Group. “A weakened immune system, decreased bladder function and hormonal changes like lower estrogen levels in post-menopausal women are a few major contributors.”

Additionally, older adults tend to be at greater risk of UTIs if they have:

• A urinary catheter

• Incontinence of the bladder or bowel

• A history of UTIs

• Dementia

• Enlarged prostate

• Diabetes

Other reasons why UTIs affect older adults differently may include age-related difficulties in identifying symptoms and increased issues with hygiene or personal care.

Recognizing UTIs in older adults

A common concern regarding UTIs in older adults is that they don’t always show the classic signs. Signs of UTIs include:

• Burning while urinating

• Frequent urination or urgent need to urinate

• A feeling the bladder is not completely empty

• Lower abdominal or pelvic pain

“In addition to the common symptoms, be on the lookout for any sudden changes in behavior, such as loss of energy or appetite,” Dr. Abedini says. “Older adults, especially those with cognitive impairments, may not be able to communicate that something is wrong, so it’s helpful to be familiar with possible symptoms.”

It’s also essential to watch for:

• Confusion or delirium

• Agitation

• Hallucinations

• Extreme fatigue

• Sudden urinary incontinence

• Falls

It’s important to note that confusion or delirium alone doesn’t always mean there’s a UTI. Older adults are prone to experiencing confusion due to various reasons, such as dehydration, medication side effects or other underlying health conditions. If a loved one shows signs of confusion, look for other UTI symptoms.

“Being vigilant about unusual or sudden changes in behavior can help in early detection and treatment,” says Dr. Abedini.

Treating UTIs

The standard treatment for a UTI is antibiotics, which kill the bacteria causing the infection. “If a UTI is suspected, a health care provider will test a urine sample and consider symptoms and other factors to determine if antibiotics are needed,” Dr. Abedini says.

More severe cases of UTI, such as those that lead to sepsis, septic shock or kidney infection, may require hospitalization and more advanced treatment.

However, not every UTI requires treatment. Asymptomatic bacteriuria, which occurs when bacteria are found in the urine without symptoms, is common in older adults.

According to Aging Health, approximately 6 to 16% of women over age 65 and nearly 20% of women over age 80 have asymptomatic bacteriuria. This condition does not usually require treatment with antibiotics, unless symptoms arise.

Preventing UTIs

Prevention is key when it comes to UTIs. Here are some tips that can help:

• Monitor fluid intake: Drinking plenty of fluids, especially water, helps flush bacteria out of the urinary tract and prevent dehydration.

• Make regular bathroom visits: Encouraging regular bathroom trips can help ensure the bladder is emptied completely.

• Maintain good hygiene: Keep the genital area clean and promptly change underwear or incontinence pads when wet.

While UTIs are a common and potentially serious issue for older adults, they can be managed effectively with awareness and proper care. If you suspect a UTI in yourself or a loved one, talk with your doctor about your symptoms and concerns for a proper diagnosis and treatment.

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