UTI's in the Elderly | Recovery Time, Signs, Symptoms & Treatment (2022)

What Are UTIs?

One of the many unseen, hard-to-detect dangers that senior citizens face today is urinary tract infections, more often known as UTIs. Though easily treatable, the symptoms of UTIs in the elderly can often mimic those of other more serious conditions, like dementia. Given that UTIs are one of the most frequent, hidden infections seniors suffer from, it is important to be able to differentiate them from other illnesses, then isolate and eliminate them. This article will give you the tools needed to combat UTIs – a formidable enemy to senior health.

A UTI is a bacterial infection of any of the four parts of the urinary system. The infection usually starts low in the urethra and moves up the ureters and into the bladder, and then goes to the kidneys. It eventually can move into the blood system if unchecked. Once the infection is in the circulatory system, it can become very dangerous and leads to sepsis, making early detection and treatment by professionals essential.

(Video) Urinary Tract Infection - Overview (signs and symptoms, pathophysiology, causes and treatment)

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.

Seniors are also more prone to UTIs because they get an assortment of ailments that cause urinary retention. There are certain health conditions they face that make it harder to pass urine, such as diabetes, kidney infections, and kidney stones. In addition to slowing the process of urinating, diabetes raises glucose in the urine, which also increases the likelihood of a UTI. An older person’s inability to urinate properly can then necessitate a catheter, which is difficult to keep sanitary, making them even more vulnerable to the same infection.

What Causes UTIs In The Elderly?

Anything that introduces bacteria into the urinary tract or impedes the flow of urine and causes urine to stay in the bladder is very likely to cause a UTI.

Eighty five percent of all UTI infections are caused by Escherichia coli or E. coli bacteria.Several other types of bacteria make up the other fifteen percent, but E.coli is by far the most prominent, and it can make its way into the urinary tract several different ways.

(Video) UTIs in the Elderly- What you need to know

E. coli is found naturally where digestion occurs in the gastrointestinal tract, so it can sneak into the urinary tract. This commonly happens because the end of the gastrointestinal tract is the anus, and the beginning of the urinary tract is the urethra. The anus and the urethra are close to one another, especially on the female body.

Due to the proximity of the entry and exit of the above two pathways, poor hygiene can cause UTIs. Back-to-front wiping after a bowel movement can transfer bacteria into the urethra. Wearing soiled underwear or disposable undergarments too long can also introduce bacteria into the urinary tract. Bacteria in both cases is an infectious traveler that multiplies.

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:

  • Confusion
  • Disorientation
  • Agitation
  • Poor motor skills
  • Dizziness
  • Falling
  • Sometimes even depression

Why is this?

(Video) Urinary Tract Infection (UTI) Signs & Symptoms (& Why They Occur)


The reason for confusion in cases of UTIs in our senior population seems to be directly linked to the fact that they are an infection, after all. Any infection will weigh down the immune system and our older folks generally won’t be feeling right when they have one.

An illuminating 2009 article in the lifestyle section of Express, a British newspaper, tells the story of Susan, a functional, vibrant, 69-year-old mother and grandmother. One Friday night, she had a headache, and then on Saturday, didn’t know her first name and couldn’t button her own buttons. Since it was too sudden to be dementia, her daughter was worried it was a stroke, so she took her mother to the hospital. The staff asked Susan simple math problems and what her age was, all of which she got wrong. This was worrying because Susan was normally a sharp woman. Doctors gave her a chest x-ray, an ECG, and a CT scan and did not get any answers. Finally, they gave her a urine test and it came up positive for a UTI! She was prescribed antibiotics and her symptoms reversed fully.

Susan’s daughter asked the doctors a question many would: why did a simple UTI cause so much confusion in her elderly mother? The doctors reported that all infections lead to dehydration, and that this affects the medication that seniors are on for other illnesses. Also, that any type of infection could cause an increase in temperature and brain inflammation, and therefore lead to mental changes.

Bottom line: if an older, loved one abruptly starts acting abnormally, the best step is to get them to urgent care so the doctors can administer proper testing to identify whether or not a UTI is the culprit.

How Are UTIs In The Elderly Treated?

Here comes some good news: after submitting to blood and urine tests and being diagnosed with a UTI, the treatment can be relatively easy. The majority of UTIs are cured by antibiotics and hydration to flush the bacteria out. This is much easier than in the past. UTIs were first documented in 1550 BC and up until the 1930’s, they were treated by herbs and bloodletting!

(Video) UTI in the Elderly

How Can UTIs In The Elderly Be Prevented?

Once a UTI infection is gone, prevention should consist of maintaining a more set schedule. Some older people start a urination schedule, setting up alarms to remind themselves to urinate. Implementing better hygiene to keep the midsection area clean and dry is also key. Seniors should regularly wear and change loose, breathable cotton underwear that can be cleaned easily. A ritual of wiping from front to back when using the bathroom is also critical.

Some urologists claim that there is an ingredient in cranberry juice that prevents bacteria, especially E coli, from adhering to the bladder wall.The ingredient is A-type proanthocyanidins or PACs. There is debate in the medical and healthcare communities as to whether there are enough PACs in cranberry juice to actually stop bacteria from grabbing on to the bladder wall. You could say that the theory has caused a healthy, sweet and sour debate! Essentially, all of these preventative measures mentioned boil down to one theme: better care.

Final Thoughts

As people age, they lose certain abilities that we all may take for granted. This is where a family member or care professional can step in and really help. Essentially, better health all boils down to better care.

For useful tips on keeping the bladder healthy to better win the battle against UTIs, check out the following advice by the US Department of Health & Human Services National Institute on Aging (NIA).


What is a common symptom of UTI in elderly? ›

Frequent, urgent need to urinate. Painful or burning urination. A constant feeling of a full bladder. Pressure or pain in your abdomen or lower back.

How long does it take for an elderly person to recover from a UTI? ›

Treatment typically lasts no more than 7 days, and your infection should clear up in a few days. It's important to drink plenty of water during treatment to help flush out the remaining bacteria. People who have two or more UTIs in 6 months or three or more UTIs in 12 months can use prophylactic antibiotics.

What is the most common cause of UTI in elderly? ›

According to the National Institutes of Health (NIH), the following conditions make older individuals more susceptible to UTIs: Diabetes. Urine retention (Weakening of the bladder and pelvic floor muscles can lead to incomplete emptying of the bladder and incontinence.) Use of a urinary catheter.

What happens when an older person gets a UTI? ›

When left untreated, UTIs in the elderly can cause serious problems, including permanent kidney damage and sepsis — a generalized and potentially life-threatening infection.

What is the first line treatment for UTI in the elderly? ›

Treatment of UTIs. When treating uncomplicated, acute cystitis in the walking-well geriatric population, the use of first-line antibiotics, such as sulfa drugs (sulfamethoxazole/trimethoprim) for 3 days or ampicillin, is sufficient. No cultures are necessary if this is a first-time event.

Can an elderly person recover from a UTI? ›

Fortunately, most seniors can recover from a urinary tract infection at home with an antibiotic. Older women who frequently develop UTIs may be given an estrogen cream to apply regularly to lower the likelihood of repeat infections. If a UTI turns into a kidney infection, hospitalization may be necessary.

What is the best antibiotic for UTI in elderly? ›

Ciprofloxacin and levofloxacin are the most commonly prescribed fluoroquinolones for UTI. Although both are effective, ciprofloxacin has a higher potential for drug interactions and has occasionally been associated with delirium. Levofloxacin may therefore be the preferred empiric choice.

Why do UTIs cause confusion in elderly? ›

This is because as you get older, your immune response changes – it's part of normal aging. A UTI places stress on the body,” says Dr. Pearson, “and any type of stress, physical or emotional, can cause an older adult to become confused.

Why does UTI affect the brain? ›

These chemicals can also lead to many of the symptoms we feel, like fatigue or fevers. In older adults, the brain is more affected by the inflammation and the stress hormones that the body produces to fight the infection. The effects of this inflammation and stress on the brain are what show up as delirium.

Can dehydration cause UTI in elderly? ›

Dehydration increases the risk of UTIs which can lead to multiple complications including confusion, falls, AKI and hospital admission. UTIs in the elderly are often over-diagnosed and over-treated.

Why does my elderly mother keep getting urine infections? ›

Older people are more susceptible to UTIs due to a weaker flow of urine, meaning the bladder doesn't empty fully. In men, an enlarged prostate can also make it difficult to empty the bladder completely. This can lead to bacteria building up in the urine and bladder.

What are the signs of sepsis in the elderly? ›

Symptoms of severe sepsis or septic shock
  • feeling dizzy or faint.
  • a change in mental state – like confusion or disorientation.
  • diarrhoea.
  • nausea and vomiting.
  • slurred speech.
  • severe muscle pain.
  • severe breathlessness.
  • less urine production than normal – for example, not urinating for a day.
Jul 14, 2022

How do I know if my UTI has turned into sepsis? ›

If you have the following symptoms, you may have sepsis: Respiratory (breathing) rate is equal to 22 breaths per minute or higher. Systolic blood pressure is equal to or less than 100 millimeters of mercury (mm Hg) Abnormal white blood cell count (either too high or too low)

How do you treat a UTI in the elderly without antibiotics? ›

To treat a UTI without antibiotics, people can try these approaches.
  1. Stay hydrated. Drinking enough water can help prevent and treat UTIs. ...
  2. Urinate when the need arises. ...
  3. Drink cranberry juice. ...
  4. Use probiotics. ...
  5. Get enough vitamin C. ...
  6. Wipe from front to back. ...
  7. Practice good sexual hygiene.

Why do UTIs affect elderly differently? ›

This is because as you get older, your immune response changes – it's part of normal aging. A UTI places stress on the body,” says Dr. Pearson, “and any type of stress, physical or emotional, can cause an older adult to become confused.

What is the most common bacterial infection in elderly? ›

Urinary Tract Infections. Urinary tract infections (UTIs) are the most frequent bacterial infection and the most common source of bacteremia in older adults.

How do I know if my UTI has turned into sepsis? ›

If you have the following symptoms, you may have sepsis: Respiratory (breathing) rate is equal to 22 breaths per minute or higher. Systolic blood pressure is equal to or less than 100 millimeters of mercury (mm Hg) Abnormal white blood cell count (either too high or too low)


1. Home remedies for urinary tract infection or UTI (urine infection)
(Shomu's Biology)
2. UTI's and the Effects on the Brain
(Kris Chana)
3. Urinary Tract Infection Nursing NCLEX | UTI Symptoms Treatment Cystitis, Pyelonephritis, Urethritis
4. The FYI on UTIs: All you need to know to treat and prevent urinary tract infections | GMA Digital
(Good Morning America)
5. Mayo Clinic Minute: Treating Urinary Tract Infections
(Mayo Clinic)
6. Urinary Tract Infection, Causes, Signs and Symptoms, Diagnosis and Treatment.
(Medical Centric)

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