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Signs Of A Urinary Tract Infection In The Elderly

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Can A Child Get An Infection At Any Age

Urinary Tract Infections (UTI) Overview | Causes, Risk Factors, Symptoms, Diagnosis, Treatment

Other infections occur at all ages but have specific considerations in children. Several severe bacterial infections are preventable by routine immunization early in childhood. Certain children are at particular risk of bacterial infections. Sometimes doctors diagnose bacterial infections by the typical symptoms they cause.

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What Are The Signs And Symptoms Of Utis In The Elderly

Detecting UTI symptoms in seniors can be tricky because many of them affect behavior, so they can be missed or attributed to more serious illnesses.

The classic, universal symptoms for UTIs are frequent urination, burning pain, cloudy urine and lower back pain. But because senior citizens immune systems are not functioning at optimal levels, the symptoms will take a different turn and produce some unsettling side effects:

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Risk Factors For Symptomatic Uti And Asymptomatic Bacteriuria

Risk factors for symptomatic UTI in the elderly differ from those in the younger population. Factors that increase the likelihood of developing UTIs include age-related changes in immune function , exposure to nosocomial pathogens, and a higher number of comorbidities,20,21 although the strongest and most consistent risk factor for UTIs, namely a history of UTIs, is common to all age groups. Individuals with previous symptomatic UTIs have a 47 fold greater risk for future UTIs compared to those with no prior history.21,22

Relative to elderly subjects living in the community, institutionalized adults generally have more comorbidities and functional impairments, and a higher incidence of cognitive deficits, which predispose them to higher rates of asymptomatic bacteriuria and UTIs. The presence of a urinary catheter in institutionalized elderly individuals is a significant risk factor for UTIs.21 In institutionalized elderly women without a urinary catheter, the presence of bowel and/or bladder incontinence, functional disability, and dementia were significantly associated with persistent asymptomatic bacteriuria. In non-catheterized institutionalized elderly men, the only significant risk factor for persistent asymptomatic bacteriuria was cancer.23

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Role Of Urine Dipstick Testing

Dipstick testing of urine is often used as a fast method for ruling out UTI as the cause of symptoms. This test detects the presence of leucocyte esterase and nitrites . However, Gram-positive bacteria and other organisms such as Enterococci and Pseudomonas species account for larger proportion of UTI in older adults and these microorganisms do not reduce urinary nitrates to nitrites. This may mean that urine dipstick nitrite test will not test positive for these organisms.

Results from a study conducted by Juthani-Mehta et al. in nursing home residents suggests that a dipstick test result that is negative for both leukocyte esterase and nitrite can effectively exclude the diagnosis of UTI. This study, however, observed a positive predictive value of only 45% suggesting that dipstick test is not useful for identifying patients who meet laboratory criteria for UTI. Another study conducted amongst nursing home residents with asymptomatic bacteriuria also observed a very high negative predictive value of urine dipstick testing.

Cortes-Penfield et al. provide a great analogy of urine dipstick testing interpretation. They note that the clinical utility of the urinalysis for diagnosing UTI is similar to that of the D-dimer for the diagnosis of a pulmonary embolism a negative result is of great value for ruling out embolism in patients with all but the highest pre-test probabilities of disease, while a positive result is not sufficient to establish the diagnosis.

What Are The Symptoms Of A Uti In The Elderly

Elderly Urinary Tract Infection Symptoms and Risk Factors

Urinary tract infections are pretty common infections especially in women and older adults. In fact, over 1 in 3 infections in seniors living in nursing homes are UTIs. While they may be uncomfortable and annoying for younger adults, they can actually pose serious health threats to seniors. And the symptoms and side effects of a UTI may be different for seniors than younger generations, making the infection difficult to identify. In this post, we will explore the symptoms of a UTI and the health risks they can pose for seniors.

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Learn More About Infections In The Elderly

To learn more about how senior living communities work to prevent the spread of infection, and for guidance on senior living in general, contact one of A Place for Moms local senior living experts. Their expertise is provided at no cost to you. Together, theyve helped hundreds of thousands of families find a best-fit senior living solution for their loved ones.

What Are The Symptoms

It may be hard to figure out if a loved one has a UTI or not, because they may not have the classic symptoms. This is because urinary problems, such as incontinence, may have similar symptoms related to another issue, making it more difficult to recognize.

The classic, or common, symptoms of a UTI can include:

  • Burning while urinating
  • Frequent or urgent need to urinate
  • A feeling the bladder is not completely empty
  • Lower abdominal or pelvic pain

More severe symptoms of a complicated UTI can include:

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How Can I Help Prevent A Uti

Luckily, there are many things that seniors can do to help prevent UTIs. Here are a few tips:

  • Drink plenty of fluids. Seniors should drink plenty of water or other fluid to help them stay hydrated. Drinking water helps flush bacteria out of the urethra and reduces the chance of developing a UTI.
  • Drink cranberry juice. This is a classic home remedy to help with UTIs. And it has been scientifically proven. Cranberries contain A-type proanthocyanins , which help prevent bacteria from sticking to the walls of the urinary tract.
  • Wear breathable cotton underwear. If a senior doesnt experience incontinence, then this type of underwear can help reduce bacteria. Incontinence products, while effective, are associated with an increase in UTIs. If a senior needs incontinence products, make sure they change them promptly and frequently.
  • Maintain good hygiene. Genital and urinary hygiene can help keep the area clean and reduce the bacteria that could cause a UTI. Generally, the area should be kept clean and dry. Women should wipe from front to back.
  • Hire a professional. In some cases, your loved one may not have the ability to keep themselves clean and dry or to use the bathroom on their own. Proper in-home care can help your loved ones maintain their independence while also promoting safe and healthy habits.
  • Common Uti Symptoms And Signs

    Signs & Symptoms of Urinary Tract Infections | Dr Sudeep Singh Sachdeva

    The urine of most healthy, properly hydrated people appears light yellow or clear and is nearly free of odor. It also causes zero pain or discomfort to pass.

    But for the majority of people who experience a urinary tract infection, thats not the case. Instead, they will likely encounter at least one of the following indicators:

    When the kidneys are infected, other noticeable symptoms may include:

    • Fever, shaking, and chills
    • Nausea and vomiting
    • Upper back, side, or groin pain

    While its been long noted that confusion in the elderly is a sign of UTI, a 2019 report in BMC Geriatrics concludes that theres insufficient evidence connecting the symptom to that diagnosis.

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    Urine Tests Usually Dont Help If You Dont Have Uti Symptoms

    Older people often have bacteria in their urine, even if they have no urinary symptoms. This is true for nearly half of all nursing home residents.

    Doctors will often order a urine test if an older adult has vague symptoms, such as increased confusion, irritability, or falling. The test will probably show some bacteria. This may lead the doctor to order an antibiotic.

    But if the bacteria is in the urine and not causing a real infection, the antibiotic wont help the vague symptoms. There are many other reasons why an older adult might be confused or irritable, or fall.

    Social And Economic Burden

    Recurrent UTIs carry a substantial social and economic burden, and have a detrimental effect on patients quality of life .1517 The economic cost of UTIs to healthcare systems is considerable. In the United States, the cost of UTIs is estimated to be at least US$23 billion per annum.18 An economic study of 20 hospitals in eight European countries with a high prevalence of multidrug resistant Gram-negative bacteria estimated that the mean cost per case of complicated UTIs was 5700, ranging from 4028 to 7740 per case. Higher patient costs were associated with admission, infection source and severity, comorbidity, and the presence of multidrug resistant bacteria.19

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    Why Are Seniors At Risk For Utis

    Men and women older than 65 are at greater risk for UTIs. This is because both men and women tend to have more problems emptying their bladder completely as they age, causing bacteria to develop in the urinary system.

    In older men, this often happens because of a common condition called benign prostatic hyperplasia , or an enlarged prostate gland. The enlarged prostate blocks the flow of urine and prevents the bladder from fully emptying.

    Other risk factors for UTIs in older adults include:

    • Using a catheter to empty the bladder
    • Having kidney stones, which can block the flow of urine
    • Having a suppressed immune system, which lowers the bodys defense against infection

    What Is A Urinary Tract Infection

    UTIs in the Elderly: Signs, Symptoms and Treatments

    A urinary tract infection, or UTI, is the condition that results when an infection occurs in any part of your urinary system. Although theyre frequently referred to as bladder infections, UTIs can also occur in other parts of the urinary system, like the kidneys or urethra.

    General symptoms of a UTI include:

    • Frequent urination
    • Urine with a strange or strong odor
    • Feeling like you still need to go after urinating

    Its important to seek care soon if you suspect you might have a UTI. Although most patients respond well to early treatment, untreated UTIs can cause significant health complications, including kidney infections, permanent damage to your kidneys, and sepsis.

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    Why Are Seniors Susceptible To Utis

    Older individuals are vulnerable to UTIs for several reasons. The biggest culprit is an immune system weakened by time that increases susceptibility to any infection. Also, the elderly may have a diminished ability to take care of themselves. Reduced cognitive abilities and lower energy levels are issues that cause decreased hygiene and increased bacteria in seniors too. Becoming less communicative, often due to the same diminished cognitive capabilities, can be a contributing factor as well.

    Urine overstaying its welcome in the bladder is common in elderly populations, and can foster bacteria that spreads and turns into a UTI. There are several reasons this may occur. One is that seniors may lower fluid intake during the day to avoid the embarrassment and inconvenience caused by bladder control issues. This leads to less frequent urination and a pool of urine being held in the bladder much longer. Also, aging men and women undergo a gradual weakening of the muscles of the bladder and pelvic floor, or a prolapsed bladder, leading them to retain more urine and to experience incontinence.

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    Can I Prevent Urine Infections

    Unfortunately, there are few proven ways to prevent urine infections. No evidence has been found for traditional advice given, such as drinking cranberry juice or the way you wipe yourself.

    There are some measures which may help in some cases:

    • It makes sense to avoid constipation, by eating plenty of fibre and drinking enough fluid.
    • Older women with atrophic vaginitis may wish to consider hormone replacement creams or pessaries. These have been shown to help prevent urine infections.
    • If there is an underlying medical problem, treatment for this may stop urine infections occurring.
    • For some people with repeated urine infections, a preventative low dose of antibiotic taken continuously may be prescribed.

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    Know The Signs And Symptoms Of A Urinary Tract Infection In Aging Adults

    Urinary tract infections can present differently and be riskier for older adults.

    Itching. Burning. Urgency. If youve ever had the misfortune of suffering from a urinary tract infection , you recognize these symptoms all too well. For younger individuals, a UTI may be simple enough to detect and take care of. But it is usually more challenging for older adults, as symptoms can be less apparent or even significantly different in how they present.

    What Causes A Urinary Tract Infection

    Urinary Tract Infection, Causes, Signs and Symptoms, Diagnosis and Treatment.

    The main cause of UTIs, at any age, is usually bacteria. Escherichia coli is the primary cause, but other organisms can also cause a UTI.

    In older adults who use catheters or live in a nursing home or other full-time care facility, bacteria such as Enterococci and Staphylococci are more common causes.

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    That stress can result in confusion and abrupt changes in behavior in older adults with a UTI. And for seniors with Alzheimers disease or other types of dementia, any kind of stress, physical or emotional, will often make dementia temporarily worse, Forciea says.

    The Risk Of Utis As You Age

    When you think of urinary tract infections , you may think they occur mostly in young adults, especially women. But UTIs are the most common type of bacterial infection in older adults over age 65particularly for those living in nursing homes.

    While UTIs can cause mild problems for young adults, they can have more severe consequences in seniors. If left untreated, it can lead to kidney failure or sepsis, a potentially life-threatening infection in the blood.

    UTIs are a common problem seen in most medical practices, especially in older patients, said Gerald Oldham, MD, a geriatric medicine physician with Banner Health Center in Peoria, AZ. They seldom occur between ages 15-50, are more common in women and can be a severe issue in dementia patients.

    If youre caring for an older adult whos at risk for a UTI, heres what you should know to make sure they are protected.

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    How Is It Diagnosed

    If doctors suspect that a UTI is present, they will test a urine sample in the office or send it to a laboratory for a urinalysis.

    A urine culture can confirm which bacteria are causing the infection. Knowing the specific type of bacteria allows the doctor to determine a suitable treatment plan.

    A condition called asymptomatic bacteriuria is also common in older adults. ASB occurs when there are bacteria in the urine, but they do not cause any signs or symptoms of infection.

    Although ASB is common in older adults, it does not typically require treatment, unless it causes other clinical symptoms.

    The standard treatment for a UTI is antibiotics, which kill the bacteria causing the infection. Doctors will prescribe an antifungal medication instead if a fungus is causing the UTI.

    It is essential that people take the antibiotic or antifungal medication precisely according to the prescription, even if they begin to feel better. Completing the entire prescription will help to destroy all of the infectious bacteria.

    Urinary Tract Infections In Elderly Patients: How Best To Diagnose And Treat

    Retirement, Health &  Old Age Information for Aging Adults

    DALE P. MURPHY, MDSeries Editorand MARYJO CLEVELAND, MD

    How is urinary tract infection best managed in elderly persons?

    Genitourinary infection is the second most common type of infection in community-dwelling adults older than 65 years it occurs only slightly less frequently than upper respiratory tract infection. 1 The presentation of UTI in elderly patients may differ significantly from that in younger ones. Chronic urinary symptoms are common in elderly persons, and the classic triad of UTI-frequency, urgency, and dysuria-occurs routinely in older persons without infection.2 As many as one third of community- dwelling elderly women are incontinent, which can further confuse the presentation. A high index of suspicion is needed first to entertain the diagnosis and then to pursue a thorough evaluation.A variety of risk factors predispose older persons to UTIs . In those between ages 50 and 70 years, the most common are urinary tract surgery, incontinence, cystocele, high postvoid residual volume, and low estrogen levels. Neurogenic conditions of the bladderparticularly those associated with diabetes and with anticholinergic medicationalsopredispose to UTI.3 In patients older than 70 years, risk factors include the use of multiple antibiotics, the presence of an indwelling catheter, and a history of UTI.

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    How Long Can You Have Sepsis Before It Kills You

    According to researchers at the University of Michigans Institute of Healthcare Policy & Innovation , many patients die in the months and years after sepsis, but it is not known if these patients are dying because of the sepsis itself or because of other health conditions they may have. In this study, 40% of patients who survived the first 30 days of a hospitalization died within the next two years.

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