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A minor inconvenience in youth is something to watch when you’re older.

Urinary tract infections (UTIs) are uncomfortable, but usually easy to treat with a course of antibiotics. As you age, though, this simple condition can turn more serious — so knowing what to watch for is key.

Common symptoms of UTIs

UTIs are bacterial (sometimes fungal) infections in the urethra, bladder, ureter or kidneys. The urethra and bladder are part of the lower urinary tract, which is where infections happen most — and they happen most often in women. 

“Women have shorter urethras than men, which means bacteria has less distance to travel to the bladder,” says George Avetian, DO, primary care provider at Geisinger 65 Forward in Wilkes-Barre and Hazleton. “This makes women more susceptible to infection.”

Common symptoms of a UTI include:

  • Burning when urinating
  • More frequent urination
  • Lower abdominal pain (in women)
  • Cloudy urine
  • Sudden urge to urinate 
  • Urine that looks pink or brown (due to blood)
  • Strong-smelling urine

When these telltale symptoms pop up, a trip to your provider for a urinalysis and an exam, followed by a prescription for antibiotics, can lead to a simple resolution.

But if you’re an older adult, your symptoms may not be as easy to identify.

UTI symptoms in older adults

It can be more difficult to pinpoint a UTI in elderly adults, as symptoms of UTIs can be mistaken for those of other conditions. 

Some UTI symptoms in elderly adults include:

  • Confusion
  • Irritability
  • Hallucinations
  • Sudden and unexplained changes in behavior
  • Fatigue or lethargy
  • Decreased appetite
  • Dizziness
  • Frequent falls

“These symptoms can be easily mistaken for other conditions like dehydration, diabetes, Alzheimer’s or dementia,” says Dr. Avetian.

There are a few reasons why older adults are more susceptible to UTIs. Some include:

  • Lower immunity causes the infection to spread to the kidneys, which can eventually lead to sepsis if left untreated.
  • A urinary catheter makes it harder to feel normal symptoms like burning with urination.
  • Weaker pelvic floor muscles cause incontinence or have trouble expressing urine from the bladder completely.
  • Bowel incontinence can cause bacteria from the colon to spread to the urinary tract.

“Caregivers need to be especially vigilant for these symptoms in older adults in long-term care facilities,” says Dr. Avetian. 

Older women are also more susceptible than men because of their anatomy and because they produce less estrogen after menopause. This can create an imbalance of good and bad bacteria in the vagina.

Diagnosis and treatment of UTIs

A simple urine test can diagnose a UTI. And treating that UTI can prevent kidney failure and sepsis, a life-threatening blood infection. For healthy adults, antibiotics are the go-to response, but your doctor will tailor your course of treatment to your health and medication regimen.

If you’re being treated for a UTI — or you want to prevent a UTI in the first place — follow these tips:

  • Drink plenty of water/fluids, including cranberry juice (if recommended). 
  • For women, wipe from front to back after going to the bathroom to prevent transfer of bacteria.
  • Keep your genitals clean and dry.
  • If incontinent, change diapers or undergarments often. Set timers to use the restroom regularly.

Next steps: 

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