In a young person, a urinary tract infection (UTI), also known as a bladder infection, typically presents as a burning sensation during urination. It can be painful, but with proper treatment, it will be gone in a few days. But in the elderly, a UTI may not present such clear symptoms and as a result, may go undiagnosed and untreated.

Seniors experience more UTIs than any other segment of the population and women are more likely than men to get a UTI. There are several reasons for this including having a weakened immune system that comes with age, weakening of the muscles of the bladder which can lead to increased urine retention, poor bladder emptying, and incontinence. Poor hygiene, use of a urinary catheter and bowel incontinence are other factors that can contribute to infection.

According to the article, Urinary Tract Infection in the Elderly, on the site,, when a bladder infection goes untreated, the infection may spread to the kidneys and bloodstream. This can quickly become a serious problem so watch for the following symptoms that may suggest that the infection has spread:

  • Chills and shaking or night sweats
  • Fever, fatigue and a general ill feeling
  • Nausea or vomiting
  • Severe abdominal pain
  • Sudden behavioral changes, or apparent worsening of dementia

The article goes on to suggest that “elderly people with serious UTIs may not exhibit the hallmark sign of fever because their immune system is unable to mount a response to the infection. In fact, elders often don’t exhibit any of the common symptoms listed above – or don’t express them to their caregivers.”

According to National Institutes of Health (NIH), UTIs in the elderly often go undetected because the symptoms are mistaken for the early stages of dementia or Alzheimer’s. This is because symptoms of a UTI in the elderly can include:

  • Confusion or delirium-like state
  • Agitation
  • Hallucinations
  • Poor motor skills, dizziness or falling
  • Other behavioral changes

When an older adult exhibits confusion, changes in their behavior or personality, and/or becomes aggressive, most people will immediately conclude that dementia or Alzheimer’s is to blame. It is important that a UTI is considered as a possible cause of the behavior changes.

Of course, the best way to treat a UTI is to prevent it in the first place. To do so, the AgingCare article makes the following suggestions:

  • Wear cotton underwear and change them frequently
  • Always wipe from front-to-back (for a woman)
  • Keep the genital area clean
  • Set reminders/timers for those who are memory-impaired to try to use the bathroom instead of wearing an adult brief
  • Drink plenty of water
  • Drink cranberry juice (NOT if the senior has a history of kidney stones)
  • Avoid caffeine and alcohol, which irritate the bladder

One of the most important roles of a caregiver is to be an observer of behavior. Any changes in the behavior of an older adult such as confusion, aggression, decrease of appetite, or incontinence, could be a sign of a UTI and should be brought to the attention of a supervisor, or in the case of a family caregiver, a healthcare professional.