What everyone needs to know about urinary tract infections

Mature woman looking out window
Mature woman looking out window

Strategies for Well-Being

When bacteria enter the urethra and your immune system doesn’t fight them off, they may spread to the bladder and kidneys. The result is a urinary tract infection.

Many people are embarrassed to discuss UTIs, but it’s a common medical condition. UTIs are responsible for around 8.1 million doctor visits per year. Most urine infections are caused by germs – bacteria – travelling from the skin up the tubes of the urinary system. In men, this distance is further, and the end of the urine tube is further away from the germs of the guts. So men tend to get UTIs less commonly than women. Women are four times more likely to get these infections than men because their urethras are shorter than men’s urethras.

Plus, your risk increases with age. More than one-third of all infections in people in nursing homes are UTIs. Over 10 percent of women over age 65 reported having a one within the past year. That number increases to almost 30 percent in women over 85. Men also tend to experience more of these infections as they age.

As you get older, UTIs become more common. This is because you are more likely to have conditions that make it easier for germs to get access to your urinary system. In men, enlarged prostate glands prevent proper emptying of the bladder, which encourages UTIs. In women, after menopause, the tissue around the lower end of the urethra – or urinary tube – gets thinner and drier. This means the germ-repelling function works less well.

Having said that, many urine infections happen to people without these problems, just as they do in younger people.

The classic symptoms of a UTI are burning pain and frequent urination. UTIs may not cause these classic symptoms in older adults. Instead, they may experience behavioral symptoms such as confusion – especially those with dementia.

Antibiotics cure most UTIs. Without treatment, a UTI can spread to the kidneys and the bloodstream. This may lead to a life-threatening blood infection. Severe infections may require hospitalization for intravenous antibiotics. These can take weeks to resolve.

The best way to treat UTIs is to try to prevent their occurrence. These infections can be prevented or their recurrence minimized by:

• Not using douches or other feminine hygiene products.

• Not drinking fluids that tend to irritate the bladder, such as alcohol and caffeine.

• Drinking cranberry juice or taking cranberry supplement tablets, but only if you or your family does not have a history of kidney stones.

• Drink a lot of water.

Other preventative strategies include:

• Keep the genital area clean.

• If wearing adult diapers, see that they are changed regularly.

• Wear cloth undergarments.

• Women should always wipe from front to back.

Interestingly enough, elderly patients with UTI are often misdiagnosed with senior dementia or Alzheimer’s disease because a UTI can mimic symptoms of such conditions. Also, according to Nursing magazine, between 30-40 percent of elderly patients with serious infection don’t exhibit the hallmark sign of fever due to the inability of the immune system to mount a response to infection due to the effects of aging. As the bacteria in the urine spread to the bloodstream and cross the blood-brain barrier, confusion and other cognitive difficulties can be the result. Sudden onset of these symptoms should lead one to investigate possible UTI. An elderly person who is experiencing signs of mental difficulties should also be closely monitored for other signs of a UTI.

A UTI can cause confusion and other symptoms of dementia in older adults because bladder infections place stress on the body. That stress can result in confusion and abrupt changes in behavior in older adults with an elderly urinary tract infection. And for people suffering from Parkinson’s disease, Alzheimer’s disease or other dementia, any kind of stress – physical or emotional – will often make dementia temporarily worse.

UTIs can exacerbate dementia symptoms, but a UTI does not necessarily signal dementia or Alzheimer’s. These infections can cause distressing behavior changes for a person with Alzheimer’s. These changes, referred to as delirium, can develop in as little as one to two days. Symptoms of delirium can range from agitation and restlessness to hallucinations or delusions.

Further, UTIs can speed up the progression of dementia, making it crucial for caregivers to understand how to recognize and limit risks for UTIs in seniors.

Taking preventive steps and looking out for UTI symptoms should help prevent infection. If your doctor diagnoses a UTI early, your outlook is good.

Get medical attention if you suspect that you or a loved one has a UTI.

Remember, I’m not a doctor. I just sound like one.

Take good care of yourself and live the best life possible!

This column is for informational purposes only. If you have a medical condition or concern, contact your doctor or other health professional. Glenn Ellis is a Health Advocacy Communications Specialist and is available through http://www.glennellis.com.

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