UTI risk increases with age

A urinary tract infection (UTI) is a bacterial infection that occurs anywhere along the urinary tract. The urinary tract comprises:

• Kidneys, which process urine.
• Bladder, which stores urine.
• Ureters, tubes that transfer urine from the kidneys to the bladder.
• Urethra, a tube that empties urine from the bladder.

Although anyone can get a UTI, the elderly are especially susceptible and often suffer more severe symptoms. The elderly are more vulnerable mainly because their aging and weakened immune systems leave them more susceptible to infections in general.

It’s not uncommon for elderly men and women to have weakened bladder muscles, which can lead to an increase in residual urine volume, inefficient emptying of the bladder and incontinence. The ability to empty the bladder completely during urination is particularly important in terms of UTI prevention because it keeps bacteria from accumulating within the bladder. Those with weakened bladder muscles such as the elderly tend to retain urine in the bladder thus leaving them more open to bacterial infections.

In elderly men, an enlarged prostate can obstruct the flow of urination and cause urine stagnation. In elderly women, bladder prolapse, caused by a weakness in the supporting structures, can also lead to urine stagnation. Regardless of the cause, stagnant urine in the bladder becomes a breeding ground for bacterial growth and colonization, which cause UTIs.

Because the elderly immune system can be weak, it may fail to generate a normal response to infection, such as fever. This can make it difficult for early UTI detection. Consequently, UTIs among the elderly can become serious before they are even detected. Also problematic, the symptoms of a UTI in the elderly can resemble those of dementia or even Alzheimer’s disease, delaying proper diagnosis.

For a speedy and accurate diagnosis of a UTI, it is important that the elderly be closely monitored for characteristic signs. Symptoms may include:

• Urine that appears cloudy
• Bloody urine
• Strong or foul-smelling urine odor
• Frequent or urgent need to urinate
• Pain or burning with urination
• Pressure in the lower pelvis

Once properly diagnosed, the most common treatment for a UTI is a course of antibiotics.

Sometimes, a UTI can be the result of catheterization, in which case catheter use should be minimized; or, the catheter should be replaced more frequently. It is recommended that family members speak with the elderly patient’s physician or nursing staff to see what the schedule is for changing the catheter and to ensure the schedule is followed.

As with any infection, the best treatment is prevention. UTIs among the elderly can be minimized by:

• Avoiding fluids known to irritate the bladder, such as alcohol, caffeine or soft drinks.
• Drinking cranberry juice or taking cranberry supplement tablets, but only if the patient (or family) has no history of kidney stones.
• Drinking plenty of water.
• Keeping the genital area clean. If an elderly patient uses adult diapers, they must be changed regularly.
• Wearing cloth, preferably cotton, undergarments.
• Always wiping from front to back (for women).

Anyone living with or caring for an elderly family member should be aware of the potential for UTIs. Knowing how to avoid a UTI and knowing what symptoms to look out for can make all the difference in a patient’s quality of life.