While urinary tract infections are common in women, they may be misdiagnosed as a neurological disorder in seniors. Left untreated, the infection can result in permanent kidney damage. Learning how to recognize the symptoms of infection in women, seniors and even men can ensure proper diagnosis and treatment.
Symptoms of a Urinary Tract Infection
A urinary tract infection, or UTI, is an infection in any part of your urinary system: kidneys, ureters or urethra. UTIs generally occur when bacteria enter the urinary tract through the urethra and multiply in the bladder, so most infections involve the lower urinary tract, bladder and urethra.
The symptoms of a urinary tract infection depend on which part of the tract is infected.
- Upper back pain, flank pain, high fever, shaking, chills, nausea and vomiting may signal an infection involving the kidneys
- Pelvic pressure, lower abdominal pain, increased urination, painful urination and/or blood in your urine are the signs of a bladder infection, also known as cystitis
- A burning sensation during urination is a sign of an infection involving the urethra
Recognizing UTIs in Seniors
For seniors, urinary tract infections can mimic the signs of early-stage dementia, including sudden changes in behavior, confusion, delirium, dizziness, agitation and hallucinations, rather than the more common symptoms. These infections can develop into sepsis and require hospitalization.
Seniors may develop urinary tract infections for a variety of reasons, including:
- Urine retention, or the inability to empty the bladder completely
- Urinary incontinence
- Bowel incontinence, which increases the chance of contamination of the urethra
- Lack of mobility
- Diabetes
- A suppressed immune system
- Use of catheters
- Bladder dysfunction due to a neurological issue, such as stroke or multiple sclerosis
A woman recently brought her elderly mother to my office for an evaluation for Alzheimer’s disease-related dementia. The patient was confused, not eating well, weak, had an unsteady gait and had recently fallen. I ordered a urine test, which revealed that she had a urinary tract infection, not dementia. I prescribed antibiotics and the patient returned to her previous level of health.
Women and Urinary Tract Infections
Women are at a higher risk of getting UTIs than men because they have shorter urethras, meaning bacteria has a shorter trip to the bladder. This can be particularly concerning for pregnant women, who have an increased risk of premature delivery or low birth weight as a complication of developing a urinary tract infection.
Causes of urinary tract infections in women include:
- Sexual activity
- Having multiple or new sexual partners
- Pregnancy
- Poor personal hygiene
- Holding urine too long
- Dehydration
- Certain types of birth control, like diaphragms
- Menopause, which decreases estrogen, making the urinary tract more vulnerable to infection
- Wiping from back to front after going to the bathroom
Yes, Men Can Get UTIs, Too!
While it’s rare for men under 50 years of age to develop urinary tract infections, it is possible.
Causes of UTIs in men include:
- A blockage in the urinary tract (the most common cause)
- Kidney stones or an enlarged prostate, which can trap urine in the bladder
- Poor personal hygiene, particularly for uncircumcised men
Left untreated, a urinary tract infection can lead to a narrowing of the urethra in men, also known as a urethral stricture.
Treating Urinary Tract Infections
Regardless of gender, if an infection is suspected, your doctor may order a urine analysis to confirm it. Additionally, a urine culture may be performed to determine the types of bacteria growing so the most effective antibiotic can be prescribed. The antibiotics most commonly prescribed for urinary tract infections are Bactrim, Cipro, Macrobid, Ampicillin and Keflex. Older patients living in nursing homes or senior communities are more likely to be resistant to antibiotics and may require stronger and a longer course of antibiotics.
Preventing Urinary Tract Infections
To protect against urinary tract infections, I recommend:
- Drinking six to eight glasses of water each day to help flush out bacteria
- Drinking cranberry juice or taking cranberry tablets or vitamin C
- Avoiding holding urine for prolonged periods of time
- Urinating shortly after intercourse
- Taking showers instead baths
- Practicing good personal hygiene
- Using a topical estrogen cream if you’re postmenopausal, which will help promote healthy vaginal bacteria, or flora
- Avoiding feminine products such as douche, deodorant sprays and powder, which can irritate the urethra
Urinary tract infections are common but are usually easily treatable once you know the signs.
Rekha Gohel, MD is board certified in internal medicine and board certified and fellowship trained in geriatrics. She is on staff at CentraState Medical Center and may be reached at 866-CENTRA7.
