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Urinary Tract Infections in Older Adults: Symptoms and Prevention

August 24, 2023
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As we age, the risk of developing a urinary tract infection (UTI) increases for people of all genders. Infections of the urinary tract do occur more readily for those with vaginal openings because their anatomy makes it easier for bacteria to enter the body. UTIs are also more common with aging due to a variety of factors including, a weakened immune system, certain chronic health conditions and urinary and fecal incontinence. In fact, one-third of all infections in older adults occur in the urinary tract.

Unfortunately, not only are older adults at an increased risk, but UTIs can also be more difficult to diagnose. This is because their symptoms are not always the more frequent, burning and painful urination usually seen in younger adults. Read on to learn more about what causes a UTI, why older adults are at a higher risk, the symptoms to watch out for and how to better prevent infection.

What is a Urinary Tract Infection (UTI)?

The urinary tract includes the urethra—or the passageway for urine from the bladder to the outside of the body—as well as the bladder and kidneys. A UTI can occur when bacteria enters the body through the urethra and spreads to the bladder, or the kidneys in more serious cases.

Increased Risk Factors for Older Adults

Age-related factors that can increase the risk of UTIs include:

  • Catheter use
  • Bladder or fecal incontinence
  • Chronic health conditions, such as Alzheimer’s, Parkinson’s and Diabetes, can also cause bladder disfunction
  • An enlarged prostate, common in older men, can make it difficult to fully empty the bladder
  • Estrogen deficiency in post-menopausal women which is linked to bacterial growth
  • Incomplete urination caused by the side-effects of some prescription medication
  • Difficulty managing personal hygiene
  • Lack of physical activity

Classic Symptoms of a UTI

People of all ages may experience the following symptoms with a UTI:

  • Pain or burning during urination
  • Smelly or cloudy urine
  • Blood in urine–pink, red or slightly brown tinged
  • Strong and consistent urge to urinate
  • Pain in pelvis, lower back or abdomen
  • Fever and night sweats or chills
  • Nausea

UTI Symptoms in Older Adults

Some older adults may not experience any of the above symptoms with a suspected UTI. The classic UTI symptoms are usually related to the immune system working hard to fight an infection. With age, the immune response can become less effective and the body may take longer to recognize or react to an infection. This means that the infection is often more progressed before there are any obvious symptoms. In older adults, these can sometimes include:

  • Incontinence
  • Agitation
  • Fatigue
  • Dizziness and poor coordination
  • Confusion and disorientation
  • Decreased appetite

An accurate diagnosis can be difficult because these symptoms may also be confused with other age-related changes, side-effects from certain medications or symptoms of an existing chronic health condition like Alzheimer’s. And for older adults living with dementia, they may not be able to express or identify new pain or discomfort. If these symptoms or changes in demeaner come on profoundly and suddenly, you may want to investigate a possible UTI.

Prevention of UTIs

It isn’t possible to prevent all UTIs, but there are lots of steps older adults can take to reduce the chance of infection. Help prevent UTIs by doing the following:

  • Drink lots of fluids
  • Empty the bladder completely and always as soon as the urge hits
  • Regularly change incontinence briefs
  • Avoid caffeine and alcohol which can irritate the bladder
  • Keep the genital area clean
  • Wipe from front to back after bowel movements and after urinating (for people with vaginal openings)
  • Wash your hands regularly
  • Urinate after sexual activity
  • Wear breathable, cotton underwear
  • Avoid douches, sprays or powders in the genital area
  • Take a cranberry supplement or drink 100% cranberry juice—research shows that a compound found in cranberries known as proanthocyanidins, may prevent bacteria from sticking to the walls of the bladder
  • Consider a daily probiotic, also proven to prevent the growth of bad bacteria which can cause recurrent infections

If you suspect that you or a loved one has a UTI, see your health care provider immediately. UTIs are usually treated quickly and effectively with oral antibiotics, but in some advanced cases you may need intravenous antibiotics.

Left untreated, UTIs can cause kidney infections, lead to kidney failure or spread to the bloodstream causing sepsis, or blood poisoning. However, knowing how to better prevent infection, along with awareness around the symptoms to watch out for, UTIs in older adults can be managed effectively.

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