UTI and the Elderly

My Mother Is Suddenly Exhibiting Confusion. Does She Have Dementia?

Urinary tract infections, or UTIs, are the most common bacterial infection in older
adults, affecting women more often than men.

UTIs can typically be treated effectively with antibiotics once diagnosed. Unfortunately, not all
UTIs are treated quickly, and some aren’t even identified, particularly in seniors. Typical UTI
symptoms like burning and frequent urination often do not appear in seniors — or they may be
too subtle for family caregivers to notice. Seniors experiencing UTIs can show a sudden change
in behavior and symptoms that may appear to be associated with cognitive issues, such as:

    • Frequent falls
    • Confusion
    • Dizziness
    • Agitation or aggression
    • Fatigue and lethargy
    • Decreased appetite

These symptoms may be interpreted as signs of aging or dementia, but if there is a sudden
change in abilities, behaviors, or disposition, it may be an undiagnosed UTI.

What is a UTI?

The urinary system is the body’s drainage system for removing wastes and extra water. It includes
two kidneys, two ureters, a bladder, and a urethra. Urinary tract infections (UTIs) are the second
most common type of infection in the body.

You may have a UTI if you notice:

    • Pain or burning when you urinate
    • Fever, tiredness, or shakiness
    • An urge to urinate often
    • Pressure in your lower belly
    • Urine that smells bad or looks cloudy or reddish
    • Pain in your back or side below the ribs

What causes a UTI in an elderly person?

Older adults are more vulnerable to UTIs because as we age, we tend to have weaker muscles
in our bladder and pelvic floor that can cause urine retention or incontinence. Whenever the
urine stays in the urinary tract, there’s a potential for bacteria, such as Escherichia coli, or E.coli

What are the symptoms of a UTI?

When typical, healthy adults get a UTI, the symptoms are usually easy to identify, and the
infection is simple to diagnose:

    • Frequent, urgent need to urinate
    • Painful or burning urination
    • A constant feeling of a full bladder
    • Pressure or pain in your abdomen or lower back
    • Dark, cloudy, or thick urine

If left untreated, a person may experience:

    • Fatigue
    • Nausea and vomiting
    • Fever
    • Pain in the lower to the mid back where your kidneys are located

What makes seniors more vulnerable to a UTI?

UTIs appear more frequently in people who have health conditions more common to seniors

such as diabetes, catheter usage, incontinence, immobility, or kidney stones. Seniors can easily
become dehydrated, which can contribute to more frequent UTIs. Women who have gone
through menopause are also more likely to get a UTI.

How do you treat a UTI in seniors?

If you suspect a UTI, your healthcare provider can perform urinalysis or other tests to confirm
the diagnosis and then prescribe antibiotics if needed.

How can UTIs be prevented in seniors?

A few simple steps and healthier habits can cut down the frequency of senior UTIs.
Women should always wipe from front to back, moving any bacteria away from the urethral
opening. Caregivers should also follow these protocols.
Urinary catheters should be inserted in the cleanest possible environment and protected from

Make sure seniors stay hydrated and drink plenty of water to help flush bacteria from the

What if a UTI goes untreated?

An untreated UTI can spread to the kidneys, which is a more severe infection. UTIs can also
lead to sepsis, which can be fatal. UTIs cause more than half the cases of urosepsis among
older adults.

Some seniors might not feel comfortable bringing up the symptoms of discomfort to caregivers
or loved ones or they may not experience any urinary symptoms, so it’s important to be aware
of and watch for the UTI symptoms specific to seniors.
A UTI left undiagnosed – or misdiagnosed as symptoms of dementia or aging — can be
extremely harmful to a senior’s health. Keep watch for the signs of senior UTIs to help protect
their overall health.

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