Elderly Urinary Tract Infections

Though seniors are at an increased risk of developing UTIs, identifying symptoms in a timely fashion and treating the infection can lower the chance of such harmful consequences.

While urinary tract infections (UTIs) are an annoyance, it is critical to deal with and manage them promptly. Without appropriate care and treatment, bacteria in the urinary tract can lead to severe health complications and even be fatal. Though seniors are at an increased risk of developing UTIs, identifying symptoms in a timely fashion and treating the infection can lower the chance of such harmful consequences.

What Are Urinary Tract Infections?

Urinary tract infections (UTIs) occur when germs infect the tract that transports urine from the body, which includes the kidneys, bladder, ureters, and urethra. When bacteria (usually E. coli) is introduced into the urinary system and travels up the urethra to the bladder, an infection can occur. Since women have a shorter urethra compared to men, they are more susceptible to urinary tract infections. Sexual activity, urinary tract abnormalities and blockages, and recent procedures of the urinary system can also increase UTI risk. Additionally, UTIs are among the most common infections in the elderly, with the following factors making older individuals more vulnerable to them:

Compromised Immune System

Seniors are overall susceptible to infections, including UTIs, related to a compromised immune system that often occurs with advancing age.

Muscle Loss and Weakening

Seniors are at risk at muscle loss, which may cause muscle weakening of the bladder and pelvic floor, subsequently increasing urine retention. Men with an enlarged prostate can also prevent the bladder from fully emptying. Ultimately, not completely emptying the bladder and holding urine increases the chance of UTIs.


When women experience menopause, they have lower levels of estrogen. Lower levels of this hormone may cause the urethra to thin and change the balance of bacteria, subsequently making infections more likely.

Catheter Use

A catheter is a thin tube inserted through the urethra to carry urine out of the body and are used if one cannot urinate on their own. While they do offer benefit to the individual, their use can increase the risk of infection if bacteria enters through the catheter and reaches the bladder. Catheter and UTI risk is often a problem for older adults who are hospitalized, paralyzed, or have a neurological condition, which makes it difficult to control the ability to urinate.

Urinary Tract Infection Symptoms

Symptoms are generally broken down to the organ affected, including bladder and kidney infections:

Bladder Infection

Bladder infections lead to cystitis, or when the bladder swells and becomes inflamed. They are recognized as being uncomfortable and likely cause the following symptoms:

  • A burning feeling when urinating
  • A frequent or intense urge to urinate
  • Urinating only in small amounts at a time
  • Pain or pressure around the pelvis
  • Cloudy, dark, bloody, and/or strange-smelling urine
  • Feeling tired and fatigued

Kidney Infection

The main danger associated with untreated UTIs is the infection may spread from the bladder to one or both of the kidneys, which can compromise kidney function and potentially cause kidney failure. Common symptoms of a kidney infection include:

  • Pain on either side of the lower back
  • Fever and chills
  • Nausea and vomiting

However, symptoms may not follow the classic pattern in the elderly. Agitation, delirium, or other behavioral changes may be the only sign of a urinary tact infection in elderly men and women. Prolonged fatigue and mental confusion can also be indicative of a more serious UTI.

Diagnosing and Treating UTIs

It is absolutely imperative to seek medical help if symptoms are present, as unmanaged UTIs can be life-threatening. A healthcare provider will do a physical exam and discuss symptoms, alongside conducting a urinalysis, a urine test that detects for bacteria and abnormal white and red blood cell counts. While at-home test kits are available and can help detect a UTI, they are not 100 percent accurate and results and symptoms should still be discussed with a doctor. Advanced exams may be conducted to detect the underlying cause if UTIs are recurring, including a cystoscopy, ultrasound, and tests utilizing contrast dyes.

If diagnosed with a UTI, an over-the- counter drug called phenazopyridine can relieve the pain, burning, and irritation, along with controlling the need to urinate frequently and urgently. However, while the medication may ease symptoms, it does not cure the infection itself. Prescription antibiotics are the gold standard to cure a UTI and are generally taken over a course of three to seven days. But for stronger conditions and if managing other health conditions, the antibiotic is likely to be prescribed for a longer duration. Additionally, doctors may recommend an estrogen-containing vaginal cream for post-menopausal women. Aside from medication, a health care provider is likely to encourage an increased fluid intake to help empty the bladder and flush out the bacteria. Delayed or unsuccessful management of UTIs increases the risk of the infection to travel to the kidneys, which generally requires hospital care and a course of intravenous (IV) antibiotics. Nonetheless, treatment of UTIs depend on its severity and is individualized to fight off the infection and additional consequences that may arise.

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