Urinary Tract Infections in the Elderly

When bacteria enter the urethra and your immune system doesn’t fight them off, they may spread to the bladder and kidneys. The result is a Urinary tract infection (UTI).

Urinary tract infections (UTIs) are responsible for around 8.1 million doctor visits per year. Most urine infections are caused by germs (bacteria) travelling from the skin up the tubes of the urinary system. In men, this distance is further, and the end of the urine tube is further away from the germs of the guts. So men tend to get urinary tract infections (UTIs) less commonly than women. Women are four times more likely to get UTIs than men because their urethras are shorter than men’s urethras.

Your UTI risk increases with age. More than one-third of all infections in people in nursing homes are UTIs. Over 10 percent of women over age 65 report having a UTI within the past year. That number increases to almost thirty percent in women over 85. Men also tend to experience more UTIs as they age.

As you get older, UTIs become more common. This is because you are more likely to have conditions which make it easier for germs to get access to your urinary system. In men, enlarged prostate glands prevent proper emptying of the bladder, which encourages UTIs. In women, after menopause the tissue around the lower end of the urinary tube (urethra) gets thinner and drier. This means the germ-repelling function works less well.

Having said that, many urine infections happen to people without these problems, just as they do in younger people.

Interestingly enough, the elderly with a UTI are often misdiagnosed with senior dementia or Alzheimer’s disease, because a UTI can mimic symptoms of such conditions. Also, according to Nursing magazine, between 30% and 40% of elderly patients with serious infection don’t exhibit the hallmark sign of fever due to the inability of the immune system to mount a response to infection due to the effects of aging. As the bacteria in the urine spread to the bloodstream and cross the blood-brain barrier, confusion and other cognitive difficulties can be the result. Sudden onset of these symptoms should lead one to investigate possible UTI. An elderly person who is experiencing signs of mental difficulties should also be closely monitored for other signs of a UTI.

The classic symptoms of a urinary tract infection (UTI) are burning pain and frequent urination. UTIs may not cause these classic symptoms in older adults. Instead, older adults, especially those with dementia, may experience behavioral symptoms such as confusion.

Antibiotics cure most UTIs. Without treatment, a UTI can spread to the kidneys and the bloodstream. This may lead to a life-threatening blood infection. Severe infections may require hospitalization for intravenous antibiotics. These can take weeks to resolve.

The best way to treat UTIs in the elderly, or anyone for that matter, is to try to prevent their occurrence. UTIs can be prevented or their recurrence minimized by: Not using douches or other feminine hygiene products; Not drinking fluids that tend to irritate the bladder, such as alcohol and caffeine; Drinking cranberry juice or taking cranberry supplement tablets, but only if you or your family does not have a history of kidney stones; Drinking lots of water;

Keeping the genital area clean; If wearing adult diapers see that they are changed regularly; Wear cloth undergarments; and Always wiping from front to back (for women).

A UTI can cause confusion and other symptoms of dementia in older adults. A bladder infection places stress on the body. That stress can result in confusion and abrupt changes in behavior in older adults with an elderly urinary tract infection. And for people suffering from Parkinson’s disease, Alzheimer’s disease, or other dementia; any kind of stress, physical or emotional, will often make dementia temporarily worse.

Urinary tract infections can exacerbate dementia symptoms, but a UTI does not necessarily signal dementia or Alzheimer’s. UTIs can cause distressing behavior changes for a person with Alzheimer’s. These changes, referred to as delirium, can develop in as little as one to two days. Symptoms of delirium can range from agitation and restlessness to hallucinations or delusions.

Further, UTIs can speed up the progression of dementia, making it crucial for caregivers to understand how to recognize and limit risks for UTIs in seniors.

Taking preventive steps and looking out for UTI symptoms should help prevent infection. If your doctor diagnoses a UTI early, your outlook is good.

Get medical attention if you suspect that you or a loved one has a UTI. Remember, I’m not a doctor. I just sound like one. Take good care of yourself and live the best life possible!

The information included in this column is for educational purposes only. It is not intended nor implied to be a substitute for professional medical advice. The reader should always consult his or her healthcare provider to determine the appropriateness of the information for their own situation or if they have any questions regarding a medical condition or treatment plan. Glenn Ellis, is a Health Advocacy Communications Specialist. He is the author of Which Doctor?, and Information is the Best Medicine. A health columnist and radio commentator who lectures, nationally and internationally on health related topics, Ellis is an active media contributor on Health Equity and Medical Ethics. Listen to Glenn, every Saturday at 9:00am (EST) on www. wurdradio.com, and Sundays at 8:30am (EST) on www.wdasfm.com. For more good health information, visit: www.glennellis.com