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What Causes Frequent Urinary Tract Infections In The Elderly

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What Are The Symptoms

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

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:

Treatment Considerations In Older Adults

Dr N: She told me that her incontinence had definitely gotten worse in the last couple of weeks. I had noticed that another physician had sent a urine culture that had grown more than 105 CFU/mL of E coli that was sensitive to all antibiotics. Assuming that this was asymptomatic bacteriuria, it was not treated with antibiotics. A repeat urine culture again showed more than 105 CFU/mL of E coli, again it was pan sensitive. Given her symptoms, I treated her with a 7-day course of an antibiotic. However the antibiotics didnt really make a difference.

Studies have shown that treatment of asymptomatic bacteriuria does eradicate bacteriuria. However, reinfection rates , adverse antimicrobial drug effects, and isolation of increasingly resistant organisms occur more commonly in the therapy vs nontherapy groups. No differences in genitourinary morbidity or mortality were observed between the 2 groups.

Urinary tract infections, or UTIs, are more than a painful medical condition. Left untreated, these infections can spread through the body. The leading cause of sepsis, an untreated UTI can ultimately result in death. For caregivers of elderly patients, learning how to recognize a UTI can be tricky as the symptoms are varied. Fortunately, there are three easy ways to avoid the onset of the infection to begin with.

How Urinary Tract Infections Affect The Elderly

Elderly patients who need catheters to urinate are at increased risk for urinary tract infections, especially if they recently had surgery for urinary dysfunction.

Older people who have a depressed immune system, like diabetes, may also not be able to naturally protect themselves against the bacteria. This can lead to current urinary tract infections.

Elderly men who have an enlarged prostate can suffer complications that increase their risk for urinary tract infections. The abnormal prostate can trap urine inside the bladder, which leads to recurrent urinary tract infections.

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Risk Factors For Urinary Tract Infections

And now a brief note about reproductive parts: Although people with penises do get UTIs, people with vaginas are more at risk. It all boils down to the anatomy, Minkin says.

Bacteria that cause UTIs often make their way from the back door to the front and then up the urethra to wreak havoc on the urinary system.

Because the male reproductive system has a longer urethra than the female reproductive system, the bacteria have farther to travel, which makes it more difficult for a UTI to develop.

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Tips To Keep Your Bladder Healthy

Urinary Tract Infection (UTI): Overview and More

People rarely talk about bladder health, but everyone is affected by it. Located in the lower abdomen, the bladder is a hollow organ, much like a balloon, that stores urine. Urine contains waste and extra fluid left over after the body takes what it needs from what we eat and drink. Each day, adults pass about a quart and a half of urine through the bladder and out of the body.

As people get older, the bladder changes. The elastic bladder tissue may toughen and become less stretchy. A less flexible bladder cannot hold as much urine as before and might make you go to the bathroom more often. The bladder wall and pelvic floor muscles may weaken, making it harder to empty the bladder fully and causing urine to leak.

While you cant control everything that affects your bladder, here are 15 steps you can take to keep it as healthy as possible:

  • Use the bathroom often and when needed. Try to urinate at least once every 3 to 4 hours. Holding urine in your bladder for too long can weaken your bladder muscles and make a bladder infection more likely.
  • Be in a relaxed position while urinating. Relaxing the muscles around the bladder will make it easier to empty the bladder. For women, hovering over the toilet seat may make it hard to relax, so it is best to sit on the toilet seat.
  • Wipe from front to back after using the toilet. Women should wipe from front to back to keep gut bacteria from getting into the urethra. This step is most important after a bowel movement.
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    Confusion Linked To Acute Cystitis Or Pyelonephritis

    Studies including hospitalised patients are likely to also include patients with pyelonephritis, a condition likely to result in confusion in a fragile elderly person. However, the typical nursing home situation usually involves the suspicion of confusion caused by a lower UTI in an afebrile patient.

    The primary aim of this review was not to evaluate the association between pyelonephritis and confusion. The primary question was if lower UTI with no fever in residents without a urinary catheter, with or without localised symptoms such as acute dysuria, urgency or frequency, is associated with confusion. This review concludes that current evidence does not provide a clear answer to this question.

    What About Confusion And Disorientation

    While confusion or disorientation are sometimes associated with UTIs in older adults, particularly those ages 70 or older, Dr. Slopnick says its important to understand that a UTI doesnt necessarily come with any signs of confusion. And signs of confusion dont necessarily point to a UTI.

    Aging naturally increases the incidence of confusion and delirium, especially among those who are cognitively impaired, depressed, malnourished or completely dependent.

    If someone is suddenly showing signs of confusion, your doctor may check for a UTI. But confusion alone isnt a telltale sign of a UTI, Dr. Slopnick says. Other causes should be investigated as well, especially if the person isnt showing other classic UTI symptoms.

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    What Are The Symptoms Of A Uti In The Elderly

    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.

    How Do Utis Affect People With Dementia

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

    If someone with dementia develops a UTI, they may quickly become more confused or agitated, or you might notice a sudden change in their behaviour. This sudden confusion is also known as delirium.

    The person with dementia may not be able to communicate how they feel, so if you notice a sudden or drastic change in them, seek medical advice. Infections can speed up the progression of dementia, so it’s important to get help quickly if you suspect someone has a UTI.

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    Infection In The Elderly: Signs And Symptoms

    Because seniors bodies respond differently to infections, they dont always show symptoms that younger patients typically do. For this reason, infections can sometimes be tricky to diagnose in seniors. Even blood samples can miss some signs of infection, since senior patients might not show a spike in their white blood cell count a common indicator of infection even if theyre sick.

    Most importantly, different types of infections cause different symptoms, and some common symptoms will present in some seniors but not others based on factors like overall health and fitness. However, there are some typical, familiar signs to watch for to spot a number of common infections in older adults:

    • Sudden headaches
    • Loss of appetite

    How Dangerous Is A Urinary Tract Infection

    Urinary tract infection often occur in older adults, it happens when a bacterial infection affect the bladder which is supposed to be a sterile environment, the seriousness of urinary tract infections and how dangerous it could be can vary from a minor medical issue easy to solve with antibiotics to a life threatening condition,

    it also depends on the overall state of health for the affected person and whether or not the infection spread to other parts and organs of the body or not.

    In most cases with UTIs symptoms are mainly related to bladder irritation such as a burning sensation while urinating, blood in the urine, pain and urge to urine frequently, oralantibiotics treatment usually result in quick improvement.

    In older adults specially ones with dementia, a UTI can cause delirium which is a worsening situation for their mental state and that can be dangerous because it put them at risk of failing and hurting themselves.

    A urinary tract infection can become even more serious when it affects the other parts of the body like the kidney or it spreads to the bloodstream, in this situation a life threatening low blood pressure may occur, intravenous antibiotics may be used to treat this spreading UTI.

    Note: There is a condition that is often confused with urinary tract infections but it isnât, Asymptomatic bacteriuria which happens when a urine culture grows bacteria, even though the person may not show any symptoms,

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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

    Antimicrobial Treatment For Symptomatic Utis

    What is Urinary Track Infections  NandiniDoctors

    Antimicrobial treatment is appropriate for symptomatic UTIs but not for asymptomatic bacteriuria.13,25 A meta-analysis of six randomized controlled trials involving 328 elderly patients with asymptomatic bacteriuria showed no significant benefit for antimicrobial treatment over placebo in the resolution of bacteriuria .3

    The 2018 EAU guidelines on urological infections3 recommend fosfomycin, pivmecillinam, or nitrofurantoin as first-line treatment for uncomplicated cystitis in adult women. Combination antimicrobial therapy with amoxicillin plus an aminoglycoside, or a second-generation cephalosporin plus an aminoglycoside, is recommended for treatment of complicated UTIs. For complicated UTI with systemic symptoms, empirical intravenous treatment with a third-generation cephalosporin is recommended. Although EAU guidelines state that fluoroquinolones may be considered for use in certain circumstances,3 the European Medical Agency has suspended or restricted their use due to disabling and potentially permanent side effects involving muscles, tendons or joints, and the nervous system. The EMA advises special caution if using quinolones or fluoroquinolones in the elderly due to their higher risk of tendon injury.26

    The increasing antimicrobial resistance of uropathogens is challenging the paradigm of empirical antibiotic therapy for symptomatic UTIs, underscoring the need for alternative treatment strategies.

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    Urinary Tract Infections And Dementia

    UTIs can cause sudden confusion in older people and people with dementia. If the person has a sudden and unexplained change in their behaviour, such as increased confusion, agitation, or withdrawal, this may be because of a UTI.

    The person may not be able to communicate how they feel, therefore it is helpful to be familiar with the symptoms of UTIs and seek medical help to ensure they get the correct treatment.

    It is also important to be aware that any infection could speed up the progression of dementia and so all infections should be identified and treated quickly.

    UTIs and delirium

    Uti And Confusion In The Elderly: Can A Urinary Tract Infection Cause Dementia

    When it comes to the elderly, its important to respect them, their privacy, and their autonomy, even when it comes to life and death situations involving their health. However, there are several instances that could be concerning and must be addressed quickly in order to avoid complications, and in many cases, the senior may not be aware of the underlying issue or may not notice the symptoms.

    This can be the case with a urinary tract infection, or UTI. For most younger people, UTIs are a minor irritation. In the elderly, urinary tract infections are a potential killer. Even more concerning, the symptoms of a UTI in senior citizens may not be readily apparent to caretakers without proper education.

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    Who Is Affected By Utis And How Are They Treated

    Women are more commonly affected by them than men. Around half of women will need treatment for at least one UTI during their lifetime.

    If treated with the right antibiotics, UTIs normally cause no further problems and the infection soon passes. Though complications are uncommon, they can be serious and include kidney damage and blood poisoning, which can be fatal.

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    Urinary Tract Infections In Men

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    Men can get UTIs, particularly if they have trouble with urine flow. Older men who experience prostatitis are at a higher risk. If the bladder is not emptying properly, the build up ofurine makes it more difficult to cure the infection.

    A small number of young men may get a UTI. In males, this is usually the result of a sexually transmitted disease.

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    When To See A Doctor

    If you suspect you or a loved one has a UTI, its best to see a healthcare provider. Symptoms like painful, urgent or frequent urination shouldnt be ignored, Dr. Slopnick stresses.

    Your doctor will ask about symptoms and perform a urine culture and possibly other tests to confirm if a UTI is to blame. If youre experiencing multiple UTIs a year, your doctor may also order other tests to better understand if a prolapsed bladder, enlarged prostate or other condition is causing frequent infection.

    How Common Are Urine Infections

    Urine infections are much more common in women. This is because in women the urethra – the tube from the bladder that passes out urine – is shorter. Also it opens nearer the back passage than in men. Half of all women will have a urine infection that needs treating in their lifetime.

    Urine infections are less common in men. They are very uncommon in young and middle-aged men. They are more common in older men. They are more likely to occur in men who have to use a catheter. A catheter is a thin, flexible, hollow tube used to drain urine. Older men are more likely to need a catheter because of prostate problems, which become more common with age.

    Urine infections tend to become more common as you get older.

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    Senior Uti Do You Know The Symptoms

    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 arent even identified, particularly in seniors.

    What is a UTI?

    A UTI is an infection in the urinary tract. The urinary tract includes the kidneys, bladder, ureters and the urethra which carries urine out of the body. They are most commonly caused by bacteria but can also be a fungal infection.

    A lower UTI is a common infection, affecting the lower part of the urinary tract, the urethra and urinary bladder. Infection of the urethra is urethritis while a bladder infection is cystitis. An upper UTI affects the kidneys.

    What causes a UTI?

    A typical bacterial UTI is caused by bacteria, often fecal bacteria, entering the urethra through the urethral opening where urine is released from the body. Usually, the body can fight off these bacteria and prevent infection. However, if the immune system is too weak, the bacteria multiply, causing infection.

    Fungal UTIs usually stem from fungus in the bloodstream. Fungal UTIs are relatively uncommon, impacting mainly those with illnesses that compromised their immune system.

    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:

    If left untreated, a person may experience:

    What Are The Common Symptoms

    5 Phases to Heal UTIs Naturally

    Common symptoms of a UTI infection include the following:

    • Dark or cloudy urine
    • Pain or burning sensation during urination
    • Pressure or tenderness in the lower abdomen
    • Low-grade fever
    • Night sweats, shaking, or chills

    However, older adults may not experience any of these symptoms when they have a UTI, which can make identifying the infection difficult. This is due to the fact that seniors have weakened immune systems that arent able to respond to bacterial infections as effectively. The symptoms mentioned above are actually signs that the immune system is working to fight the infection off.

    Seniors have a unique set of symptoms as a result of a UTI, including the following:

    • Poor coordination, which can lead to falling

    Usually, these symptoms will appear suddenly if the cause is an infection. But many of these symptoms could be symptoms of other health conditions, like dehydration, dementia, and others. They could also be normal signs of aging, which makes it difficult to identify a UTI in a senior loved one.

    Another factor that seniors face with experiencing a UTI is a lack of communication with their loved ones or caregivers. Many seniors may choose not to tell others about their discomfort or simply cannot express it.

    The symptoms of a UTI can also change when the infection worsens and spreads to the kidneys. These symptoms include:

    • Nausea and vomiting

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