Urinary Tract Infections in Older Adults

Causes of UTIs and Why the Risk Increases With Age

Urinary tract infections (UTIs) are common in adults 65 and older, mainly due to age-related factors like malnutrition, poor bladder control, and uncontrolled diabetes.

Symptoms in Older Adults

Symptoms in older adults may also differ from those of younger people, with typical symptoms including pain during urination and atypical ones being drowsiness, confusion, loss of appetite, and delirium (a state of confusion and disorientation that usually occurs abruptly and is temporary).

Risk Factors in Older Adults

According to a 2018 study involving 931,945 older adults, the rate of UTIs in adults over age 85 is more than double that of adults age 65 to 74. In fact, after the age of 85, around 74% of men and 85% of women will have been diagnosed with a UTI. Many factors account for this, including:

• Enlarged prostate
• Exposure to bacteria in skilled nursing facilities
• Functional disability (the inability to adequately care for oneself independently)
• Having multiple comorbidities (coexisting health conditions), including diabetes, chronic kidney disease, or stroke
• History of UTIs (a risk factor at any age)
• Immunosenescence (the aging-related decline of the immune system)
• Impaired cognitive function, including dementia

Ways to Prevent UTIs

UTIs are common. As such, it can be difficult to avoid. The standard methods of prevention of UTIs include:

• Keeping well hydrated: Older adults are especially prone to dehydration, which can concentrate bacteria in urine. By keeping well hydrated, you can help flush bacteria from your urinary tract. Plain water works best.
• Practicing good hygiene: For females, this includes wiping from front to back after a bowel movement, which reduces exposure to bacteria from stool. Also, avoid long baths; showers are better to prevent skin bacteria from entering the bathwater and your urethra.
• Urinating often: "Holding it in" allows bacteria to multiply in your urine and establish an infection. Doing so also weakens the bladder, making it increasingly more difficult to fully empty it.
• Using vaginal estrogen: A drop in estrogen levels after menopause (cessation of menstrual periods) can throw off the balance of vaginal bacteria. It can also make tissues around the urethra thinner and more susceptible to infection. A topical estrogen cream can help prevent this.
• Wearing breathable cotton underwear: This reduces the heat and moisture around the genitals, which promotes bacterial growth. Change your underwear daily, and carry an extra pair with you if you are prone to bladder leakage and have an accident.

Prevention for Loved Ones Who Are Physically Weak or Bedridden

If you have a loved one who is physically weak or bedridden, you can reduce the risk of UTIs by:

• Maintaining proper sanitation: This includes changing underwear daily or when soiled, changing wet or soiled bedding immediately, and having someone on hand to assist with regular toileting and bathing.
• Maintaining hydration: The amount of water can vary but is generally around 8.5 cups (2 liters) per day for most adults. Avoid alcohol and caffeine, which can irritate the bladder and promote urination. Monitor water intake closely to avoid dehydration.
• Practicing catheter safety: The genitals and groin should be cleaned twice daily in people with indwelling catheters. Urine should be drained from the collection bag when it is two-thirds full. Strict sanitary practices should be maintained when inserting or removing standard catheters.

Conclusion

UTIs are a common problem in older adults, and it is essential to be aware of the risk factors and prevention methods to reduce the likelihood of developing this infection.

Frequently Asked Questions

• What are the symptoms of UTIs in older adults?
  • Pain during urination, drowsiness, confusion, loss of appetite, and delirium
• What are the risk factors for UTIs in older adults?
  • Malnutrition, poor bladder control, uncontrolled diabetes, enlarged prostate, and immunosenescence
• How can I prevent UTIs?
  • Keep well hydrated, practice good hygiene, urinate often, use vaginal estrogen, and wear breathable underwear

Note: The above content is a rewritten version of the provided article, organized with appropriate headings and subheadings, and including a conclusion section and FAQs section at the end.