UTI or urine infections are quite common in elderly populations. They tend to affect women more than men; though elderly male patients placed on catheters could also get urine infections frequently. The problem with treating UTI in the elderly is that they are often asymptomatic. As a result, they tend to go unnoticed for a long time leading to various complications. In normally alert and active elderly people, UTIs typically present themselves in the form of sudden and unexplained delirium or confusion. In this guide, we will consider everything there is one needs to know when dealing with UTI in the elderly, particularly complications that may arise with it, as well as methods of treating and preventing them.
UTI in the elderly: Complications and symptoms
Can a UTI affect an older patient’s mental state?
Asymptomatic urine infections in the elderly often do not produce any of the regular symptoms such as burning pain during urinating, fever, abdominal pain etc that are typically seen in younger patients. The main symptoms of urine infection in elderly populations include:
- Behavior changes, confusion and memory loss that seem to strike suddenly: s/he might not be able to perform daily tasks such as buttoning clothes or feeding oneself etc. Many cannot remember the current year, their maiden name, their address or the year they were born in.
- Fatigue and weakness are some other symptoms of UTI in elderly
- The person might appear depressed, undernourished and dehydrated.
- Foul smelling urine might be produced
When left untreated for long, UTI in elderly could cause sepsis. This is characterized by high fever, rapid and irregular heartbeat and even septic shock where there is dangerous lowering of blood pressure. Thus, to answer the question: whether urine infections in the elderly are fatal, the answer is yes. In patients already having weakened immunity or those with heart valve problems, the sudden lowering of blood pressure caused by sepsis can be life threatening. Other than sepsis, urine infections in the elderly can also lead to Pylonephritis as well as permanent kidney damage. The patient might require dialysis to remove the waste from the blood.
Why does UTI lead to confusion and dementia in the elderly?
Every urine infection is a by-product of dehydration and vice a versa. If a patient is already taking medicines for other conditions, these might be affected by the dehydration. Additionally, UTIs in the elderly lead to brain inflammation and temperature changes which could affect a person’s thinking and cognitive functions.
The reason UTI-induced-delirium in elderly is more dangerous because; in such a state, the person is more susceptible to falls, accidents and irrational behavior.
Causes of UTIs in elderly patients
As stated before, women aged 60 and above are more prone to UTIs than men owing to the proximity of the urethral opening and anus. The germs from the anus easily travel to the urethra and bladder due to back-to-front wiping after bowel movement. Also, uterine prolapse, a condition where the walls and muscles of the uterus become structurally weak causing problems emptying the bladder completely can lead to UTIs in elderly females. Urine incontinent men and women who require diapers are more likely to trap germs in the urethra. Elderly patients (of both sexes) having diseases like cancer, diabetes etc could also suffer frequent bladder infections. Other reasons for UTIs in the older populations include the use of catheters. Indwelling catheters generally trap germs despite precautions.
Treating Urine infections in the elderly
It is important to get a dipstick urine test done for patients suspected of having UTI. If s/he is showing signs of dementia, a loved one or caregiver must assist them for collecting early morning sample of urine. A culture test can help the doctor diagnose if it is a lower UTI or upper UTI. The former are slightly easier to treat and they generally respond well to antibiotics. Upper bladder infections might involve kidneys and ureters apart from the bladder and could end up being fatal. In case of UTI in elderly accompanied by confusion and delirium, apart from antibiotics, short-term treatment with anti-psychotic drugs may be needed.
Preventing UTIs in elderly
Recurrent urine infections in elderly are a common problem. To prevent them, it is vital to get a urine test done every few months. Family members should also watch out for confusion, difference in behavior, unusual sleepiness, hallucinations etc in the patients prone to such infections.
- Patients with low mobility should have easy access to water. Color coded glasses/cups can be used for this purpose to assess the water drunk on daily basis. Drinking up to 6-8 glasses of water daily is recommended.
- It is important that patients empty their bladder frequently. Bathrooms must be equipped with handrails etc to prevent falls. A night light should be placed in the bathroom as well.
- Moderate exercise with good diet having fibrous foods is recommended to prevent constipation.
- Some evidence supports that UTIs in elderly can be prevented with regular consumption of cranberry supplements or juices.
- In case of urinary catheter being used precautions must be followed as stated by the medical expert.
These are some ways of treating and preventing UTIs in the elderly.