A urinary tract infection (UTI) occurs when bacteria enter the urinary tract.  The most common type of UTI develops in the bladder (cystitis), but it can also occur in the kidney (pyelonephritis).  Urinary tract infections account for 25-50% of infections in those aged 65 and older.  They are one of the most commonly diagnosed infections in older adults and a leading cause of infection-related hospitalizations for this age in group.  In this blog, we will explore the risk factors, signs and symptoms, how it is diagnosed, and most importantly, strategies for preventing urinary tract infections.

Risk Factors

Women are more susceptible to develop a UTI because they have a shorter urethra which allows bacteria to reach the bladder with greater ease.  Older adults are also at a higher risk, especially if they have a weakened immune system or experience urinary retention (difficulty in emptying the bladder completely, or problems urinating).  Additional factors include poor personal hygiene, reduced fluid intake, diabetes and the use of a catheter, all of which can create an environment conducive to bacterial growth and infection.

Signs and Symptoms

Pain or burning with urination
Urinary frequency
Cloudy or bloody urine
Strong odor to urine
Lower abdominal pain or back pain
Fever
Nausea or vomiting
Fatigue or weakness
Decreased appetite
Falls or unsteadiness

Other symptoms that you may not realize can be a result of a UTI, particularly in older adults, include a change in behavior, change in personality, confusion or agitation.  Sometimes cognitive changes occur without the presence of physical symptoms such as pain or fever, so it’s important to not dismiss cognitive changes, especially if the person is living with a cognitive impairment such as dementia.

Diagnosis

Diagnosing a UTI typically begins with contacting your healthcare provider.  They will likely perform a urinalysis, which involves testing a urine sample to check for signs of infection.  This test can be completed relatively quickly in a healthcare provider office.  In some cases, the urine specimen may be sent to a lab for a urine culture, which identifies the specific type of bacteria causing the infection and helps determine the most effective treatment.  If you suffer from recurring UTIs, you will want to discuss this further with your healthcare provider and try implementing some of the tips in this blog related to preventing urinary tract infections.  

Most Common Cause

While there are several causes for urinary tract infections, Escherichia coli (E. coli) is the most common bacterial cause of UTIs.  E. Coli is a type of bacteria that lives in the gastrointestinal tract without causing harm, but it can cause infection if it enters the urinary tract.

Tips for Preventing a Urinary Tract Infection

Stay hydrated – follow your healthcare provider’s recommendation for daily water intake.  Water helps cleanse the urinary system and prevents bacteria from lingering in the urethra or bladder.

Perform proper personal hygiene routinely.  Women should always wipe from front to back to avoid contaminating the urethra with bacteria from the GI tract.  

Urinate when you feel the need to rather than holding it.  Regularly emptying the bladder helps flush bacteria out.

Empty your bladder before and after sexual activity to help clear the urinary tract, and clean your genital area afterwards as well.

Avoid irritants, powders, and strong soaps as they can change the pH of your urinary tract, increasing the risk for infection.

Use cranberry tablets or cranberry juice, if approved by your healthcare provider, as this may reduce bacteria from adhering to the walls of the urinary tract.

Ensure easy access to the restroom to prevent holding urine.  Empty your bladder before leaving the home, especially if you anticipate limited access to facilities.  

Wear loose, breathable clothing and cotton underwear to reduce moisture and bacteria.

Change incontinent pads or briefs as soon as they become soiled.

Avoid caffeine and alcohol which can irritate the bladder.

Consider probiotics if recommended by your healthcare provider

Ensure proper management of diabetes, as high sugar can increase your UTI risk.

Exercise regularly to improve your circulation and immune system.

Review all of your medications with your healthcare provider – some can affect bladder function.

Complications

If left untreated, a UTI can lead to serious complications.  One potential complication is a kidney infection.  Over time, recurrent kidney infections can result in kidney damage, impairing their ability to filter waste.  In severe cases, a UTI can progress to sepsis, a life-threatening condition where the infection spreads into the bloodstream.

Conclusion

It’s important to contact your healthcare provider whenever you notice a change in physical, cognitive, or mental health, as these can be early signs of underlying conditions, such as a UTI.  UTIs are typically straightforward to diagnose or rule out through simple tests.  Addressing them promptly can prevent serious complications.  Early intervention ensures effective treatment and supports overall well-being.  By applying the tips in this blog, you can take proactive steps towards preventing urinary tract infections and reducing the risk of future health issues.

If you need help managing a chronic health condition or want to learn more about preventing urinary tract infections, please contact us to learn how we can assist you.