HEALTHY LIVING
Urinary Tract Infections Target People Over 65
Here’s all you need to know for an accurate diagnosis and eff ective treatment.
BY CHRIS ILIADES A
urinary tract infection (UTI) is the most common reason people over age 65 take antibiotics.
The problem is that about half
of them don’t need an antibiotic which, when overused, can lead to drug resistance and more serious infections. “Few elderly people are spared
from a UTI,” says Stephen Eyre, M.D., chief of the urology division at Beth Israel Deaconess Hospital-Needham and clinical instructor of surgery at Harvard Medical School. “Most are diagnosed in an
urgent care clinic using a dipstick or urinalysis. Neither of these quick tests are proof of a UTI.” After age 65, UTIs are much more
common in both men and women, and they continue to increase with advancing age. “UTIs are more common in all
women because they have a shorter urethra, which means bacteria that
82 NEWSMAX MAXLIFE | NOVEMBER 2022
cause UTIs can travel a shorter distance to reach the bladder and cause an infection,” Eyre explains. “After menopause, older women
lose some of the plump tissues in the vagina and urethra due to loss of estrogen. Loss of urethra thickness increases the ability of bacteria to penetrate the tissues and cause infection.” The immune system that fi ghts off infections weakens with age. Other risk factors include chronic diseases or conditions that make it harder to get to a bathroom, empty the bladder, or practice good bathroom hygiene. Older people who live in any
type of institution, like a nursing home, are at much higher risk due to exposure from more bacteria. The greatest risk factor is a history of previous UTIs. “Older men are more likely to have
an enlarged prostate, which leads to incomplete emptying of the bladder,” Eyre says. “This increases the chance of bacteria growing in stagnant urine.
“Older women with incontinence
who need to wear an absorbent pad are at risk if the pad is not changed frequently. A wet and warm pad is a good place for bacteria to grow and migrate up the urethra.”
UTIS MISDIAGNOSED The main reason for misdiagnosis of UTIs in older adults is asymptomatic bacteriuria (ASB). ASB is bacteria in the urine that are not dangerous. These bacteria do not cause UTIs,
but they may make a dipstick or urinalysis test positive for bacteria. To avoid mistaking ASB for a UTI, guidelines say that bacteria in urine should not be treated unless there are also symptoms of a UTI. The classic symptoms are fever,
chills, increased need to urinate, burning pain when urinating, or pressure and discomfort in the lower belly (bladder pain). Common signs include blood-
tinged, cloudy, or smelly urine. Other possible UTI symptoms in
older people are loss of appetite and constipation. The problem is that these symptoms commonly occur in seniors without a UTI.
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