Overview of Seniors and Urinary Tract Infections: What You Need to Know
If you are a senior or the caregiver for a woman or man in his or her later years, you need to have a good understanding of urinary tract infections. Urinary tract infections, or UTIs, occur more frequently as we grow older. The reality is that signs and symptoms of UTIs are now as easily recognized by older individuals. They are not apparent.
In this article, we provide you with a comprehensive overview of urinary tract infections. This includes information about symptoms of UTIs, how to treat these types of infections, and how to maintain good urinary tract health.
What Is a Urinary Tract Infection?
A urinary tract infection is a condition that can affect any part of the urinary tract. UTIs are most commonly caused by bacteria and can cause various symptoms depending on the part of the infected urinary tract. It is important to seek treatment for a UTI as soon as possible, as they can lead to more serious complications such as kidney infection or sepsis.
Urinary tract infection is an umbrella term. It actually can describe several different medical problems. To fully understand the different types of UTIs and what causes them, you need to have a general understanding of the anatomy of the urinary system. The four main parts of the human urinary system are:
- Kidneys: Where urine is produced
- Ureters: Tubes that carry urine from the kidneys to the bladder
- Bladder: The hollow organ that acts as a holding place for urine until it is excreted through urination
- Urethra: The tube that carries urine from the bladder to the outside of your body
Specific Types of Urinary Tract Infections
The exact name of a urinary tract infection depends on its location in a person’s urinary system. The four primary types of urinary tract infections:
- Cystitis is an infection in the bladder. The bacterium called E. coli is responsible for up to 90 percent of uncomplicated cystitis cases.
- Pyelonephritis is an infection in the kidneys.
- Urethritis is an infection of the urethra.
- Prostatitis is an inflammation of the prostate gland that can be caused by a UTI.
Statistics About Urinary Tract Infections
Over 8 million healthcare appointments yearly in the United States are related to urinary tract infections. The healthcare system costs associated with UTIs annually are about $3.5 billion.
A research study in Aging Health revealed that nursing home patients in the United States experienced over one-third of UTIs.
The same research study also found that over 10 percent of women over the age of 65 and 30 percent of women over the age of 85 were diagnosed with a urinary tract infection in the past 12 months.
Although the lifetime odds of getting a urinary tract infection are much more significant for women overall, the gap between women and men narrows with age. The risk of a UTI in a senior male is much closer to that of an older female. Researchers from Henry Ford Hospital found that men are more likely to be hospitalized for a urinary tract infection than women.
Reasons Seniors Have Higher Rates of Urinary Tract Infections
Since urine usually travels one way when it leaves the body, bacteria shouldn’t enter the urinary system under ideal circumstances. With that said, the urethra is very close to the rectum and surrounded by skin that harbors bacteria. When bacteria enter the urethra, it often results in infection. It is not surprising that women have a higher risk for UTIs. This is because the urethras in women are shorter. Bacteria do not have to travel as far to reach the bladder.
Several factors can make people of all genders more vulnerable to infections as they age. Some of the reasons why elderly people get UTIs at higher rates include the following:
- Urinary retention
- Incontinence
- Hormonal changes
- Obesity
- Prior infections
- Medical conditions
- Catheter use
- Other factors
Urinary Retention
You are more likely to develop a urinary tract infection if you cannot completely empty your bladder when you urinate. This is called urinary retention. Stagnant urine is a breeding ground for bacteria.
Seniors are notably more likely to experience urinary retention. Some age-related reasons for this urinary retention are:
- Bladder muscles become weaker and less flexible with age.
- Enlarged prostate glands in older men can prevent urine from flowing smoothly.
- Prolapsed bladders in women (a condition in which the bladder drops, sometimes into the vagina) can lead to difficulties in completely emptying the bladder.
- Kidney stones and constipation can block the flow of urine.
Incontinence
Both urinary and bowel incontinence can result in conditions that can result in urinary tract infections. Wearing pads or adult diapers to deal with incontinence can raise the risk if they are not changed often enough. (This is a primary contributing factor to the higher rates of UTIs among residents of nursing homes.)
Hormonal Changes
In younger women, estrogen helps provide a better balance of bacteria in the vagina and urinary tract. As estrogen declines with age, E. coli (bacteria) can grow unchecked because the number of “good” bacteria that fight E. coli also declines.
Obesity
People with higher body mass indexes also tend to have higher rates of urinary tract infections. If you gain weight with age, you could be at greater risk for a urinary tract infection.
Prior Infections
Your odds of acquiring a UTI are higher if you had one previously. The Aging Health study found that women who have gone through menopause are four times more likely to develop a urinary tract infection if they suffered one previously.
Medical Conditions
Individuals with diabetes often have weakened immunity. Therefore, they are at greater risk for urinary tract infections. Other medical conditions that are more common in older adults, including Parkinson’s disease, Alzheimer’s disease, and multiple sclerosis, are linked to increased rates of urinary tract infections. This is because they can lead to bladder problems. The medical term is “neurogenic bladder,” when disruptions in the way the brain communicates to the bladder cause problems like urinary retention.
Catheter Use
Bacteria can enter the urinary system through a catheter. Catheter-acquired urinary infections from indwelling catheters or catheters that remain attached to the body represent one of the most common causes of infections. This particularly is the case in senior long-term care facilities, according to research published in Antimicrobial Resistance and Infection Control.
Other Factors
Other factors that can result in urinary tract infections include:
- Sexual intercourse
- Poor hygiene
- Scented deodorants
- Spermicides
Symptoms of Urinary Tract Infections
Symptoms of urinary tract infections that people of any age can experience include:
- Feeling an overwhelming need to urinate immediately
- A burning sensation when you pee
- Having to urinate a lot more frequently than usual
- Pain in the pelvic region
Symptoms of urinary tract infections that seniors can experience include:
- Confusion
- Agitation
- Hallucinations
- Restlessness
- Delirium
- Lowered alertness
- Sudden unexplained incontinence
- Increased falls and other declines in physical functioning
How to Prevent Urinary Tract Infections
There are several strategies people need to follow as a means of preventing the occurrence of urinary tract infections in the first instance.
Do Not Fight the Urge to Urinate
When you feel the urge to urinate, you need to urinate promptly. It is not healthy for your bladder to hold urine for long periods. During the day, you should urinate at least every three to four hours.
Keep Hydrated
Drinking 8 to 10 glasses of water daily can help prevent the spread of bacteria. Ideally, your urine should be clear and light-colored. If you have trouble keeping track of how much water you drink, a water bottle with measurements can be helpful.
Practice Good Bathroom Routines
Do not forget good, healthy bathroom routines. Women should wipe from front to back. And some evidence suggests that when women “squat” over the toilet to avoid touching the seat, they actually raise their risk for urinary retention. This is because their bladder muscles don’t relax. Therefore, it is advisable to sit right on the toilet seat. The reality is that it is extremely rare to catch anything from a toilet seat. You can carry disinfectant wipes if you are concerned.
Let Your Skin Breathe
Letting your skin breathe is important. For women, wearing cotton underwear and avoiding tight-fitting pants is advised. Avoiding thongs is also a preventative measure worth considering. Thongs can facilitate the transfer of bacteria. Additionally, there is minimalistic, leakproof underwear for women that wick away moisture.
For men, there are similar guidelines for avoiding a urinary tract infection. This includes wearing cotton underwear and breathable pants. There is now leakproof underwear for discrete men. They provide a good option for guys who need a bit of protection but aren’t fully incontinent. You can even get leakproof boxer shorts and boxer briefs that do not outwardly show any indication of the absorbent layer.
Urinate After Sexual Intercourse
Urinating after sexual intercourse (for both men and women) is useful in clearing harmful bacteria from the urethra. Harmful bacteria can be introduced while having sex.
Keep Clean
Shower frequently. If you take baths, keep your bathing time to under 30 minutes. Avoid using products like deodorant sprays near your genital area.
Change Adult Diapers or Incontinence Pads Frequently
Be sure to change adult diapers and incontinence pads frequently. The longer soiled items are left in place, the more likely bacteria will infect the urinary tract.
Taking proactive steps like those outlined here can best protect yourself from urinate tract infections. If you experience symptoms of a urinary tract infection, see your doctor.