Urinary Tract Infections (UTIs) are an infection anywhere in the urinary tract system, though we commonly think of them as bladder infections. For most younger adults, they are a simple infection that causes pain in the low pelvis, burning with urination and frequency. However, as we age, typical symptoms are different and the infections can be more serious. UTIs are a common source of infection in the elderly, ranked #2 after upper respiratory infections. If untreated, they can lead to infection of the kidneys (pyelonephritis), sepsis (overwhelming infection in the blood stream), and even death.
Symptoms differ in the elderly, too. While older people may have typical symptoms, the most common ones are confusion (39%) and change in behavior (29%). Other common symptoms in the elderly include a change in character of the urine (blood in urine, or change in color or smell, 15.5%), fevers or chills (12.8%), and change in walking or a fall (8.8%). Difficulties with cognition or communication may make it more difficult to obtain information about other symptoms.
The elderly can be at higher risk for UTI due to a variety of reasons, including weakness in pelvic floor muscles causing urinary retention, urinary incontinence, stool incontinence, use of urinary catheters, enlarged prostate in men, use of adult diapers, history of diabetes and kidney stones, and decreased mobility.
Treatment includes taking antibiotics. Some elderly may need to be admitted for antibiotics if they are unable to take oral antibiotics, if they are seriously dehydrated, or if their caretaker is unable to provide care at home while they are more confused or weakened.
Prevention includes keeping the genital area clean and dry. If adult diapers are worn, they should be changed as quickly as possible after wetting. Women should wipe from front to back. There are conflicting results regarding the use of cranberry juice and supplements, so this should be discussed with your doctor prior to use. Ensuring adequate hydration and frequent urination are also important prevention tips.
Early recognition of UTI symptoms in older adults can ensure your loved one is treated promptly and can help avoid more serious consequences. As always, let your doctor know if you have any questions or concerns.