Urinary tract infections are a common fact of life and may happen to anyone.1 “We have a microbiome of normal, healthy bacteria that lives everywhere in our body to help fight off bad bacteria that make us sick. That’s true in the bladder and urinary tract, as well,” says urologist Emily Slopnick, MD. “As we age, that good bacteria can have a harder time fighting off infection.”2
Post-menopausal women are at highest risk of UTIs,3 with research showing that more than 10% of women over the age of 65 report having a UTI each year. That percentage increases to nearly 30% in women over the age of 85.4 Also, as men age, conditions like an enlarged prostate may prevent the bladder from emptying completely, and stagnant urine in the bladder is a primary breeding ground for the bad bacteria responsible for UTIs.5
Symptoms of UTIs in the elderly
While treatment of a UTI is rather simple and straightforward, the more difficult challenge may be the realization by the elderly that a UTI is present in the first place.6 “UTIs sometimes go undiagnosed in older adults until more severe symptoms set in,” says Howard Goldman, Vice Chairman of the Department of Urology at the Cleveland Clinic.7 These are the symptoms to be aware of, especially if they’re something new or start occurring suddenly:8
- Painful urination
Excess bacteria, usually E. coli, causes inflammation which may cause burning or stinging during urination. “That's why it’s important to note that the pain is acute or has increased in intensity lately,” says Summer Allen, Assistant Professor in the Department of Family Medicine at the Mayo Clinic. Older adults may temporarily ease any new discomfort by avoiding caffeine and alcohol.
- Sudden, unexplained urge to urinate
As people age, some already experience urination urgency or frequency. This is most often due to weakening of the bladder muscles. However, if this symptom has developed suddenly or worsened over a short period of time, a UTI may be present.
- Pain in 1 of 2 areas
Because infections often inflame surrounding tissues, UTIs may cause new discomfort in 2 distinct areas of the body—the lower pubic area near the bladder or the lower-to-mid back where the kidneys are located.
- Cloudy or foul-smelling urine
Urine that smells bad or isn’t clear when observed in the toilet may be a telltale sign of a UTI. Urine should be light yellow to medium amber and clear. Drinking plenty of fluids and emptying the bladder regularly may be helpful, flushing out UTI-causing bacteria.
- Blood in the urine
In the presence of a UTI, tissues in the bladder and urethra may become so irritated and inflamed that they bleed. That blood isn’t always obvious, but larger amounts in the urine may color toilet water pink or bright red.
- Fever
A urinary tract infection may cause a spike in body temperature. A fever of 100.4° F or higher, especially in the context of other symptoms, may indicate a UTI and may also be accompanied by chills or nausea.
- Mental fog
Even if the above symptoms aren’t present, older adults may suddenly feel mentally “off” or “not all there.” If there’s no other apparent cause, a visit to the doctor may be in order, so a UTI can either be diagnosed or ruled out.
Causes of UTIs in older adults
The most likely cause of UTIs in people of any age is bacteria, primarily E. coli, though older adults who use a catheter or live in a nursing home may develop UTIs caused by Enterococci or Staphylococci bacteria.9
Other factors may increase the risk of UTIs in seniors, including Alzheimer’s disease and Parkinson’s disease, which often require the wearing of incontinence diapers or briefs; if they aren’t changed regularly, a UTI may occur.10
In women, hormones play a major role: estrogen helps protect against the growth of bad bacteria. After menopause, those estrogen levels drop, and E. coli may trigger a UTI.11
Risk factors for men include bladder or kidney stones or an enlarged prostate.12
UTIs are also more likely for older adults who:13
- Take certain medications.
- Had radiation or surgery on the pelvis.
- Use a catheter.
- Are living with diabetes.
UTI treatments
The treatment of choice for symptomatic UTIs is antibiotics, including amoxicillin and nitrofurantoin, while broad-spectrum antibiotics like ciprofloxacin or levofloxacin may be required for more severe UTIs.14
Doctors treating seniors with antibiotics may also suggest that patients drink plenty of water to flush any remaining bacteria out of their urinary tracts.15
For pain related to UTIs, older adults may want to try over-the-counter analgesics like acetaminophen or ibuprofen, while a heating pad may help relieve pelvic or back pain.16
Preventing UTIs in older adults
Though it’s impossible to prevent all urinary tract infections, taking these steps may help reduce the risk of contracting a UTI:17
- Drink plenty of fluids.
- Urinate as soon as the urge hits.
- Avoid bladder irritants like caffeine and alcohol.
- Keeping the genital area clean.
- Change incontinence briefs frequently.
Understanding the symptoms, as well as ways to prevent infections may assist older adults to ease the pain and complications of UTIs.
Go365 by Humana® makes wellness fun and easy. We help Humana Medicare members with Go365® on their plan reach health goals, as well as take care of their physical and emotional health—allowing members to thrive at any age.
Humana Medicare members with Go365 on their plan can enroll in Go365 at
Go365 is a well-being and rewards program for many Humana Medicare Advantage members. Rewards have no cash value and can only be redeemed in the Go365 Mall. Rewards must be earned and redeemed within the same plan year. Any rewards not redeemed by December 31st will be forfeited.
If you need to enroll in Medicare Advantage or change your plan outside of the usual Medicare Annual Election Period, a Special Election Period (SEP) could be the answer. For information on eligibility, visit Humana’s
To learn more about Humana Medicare Advantage, call to speak with a licensed Humana sales agent at 1-844-321-5843 (TTY:711), Monday – Friday, 8 a.m. – 8 p.m. local time or visit
Sources:
1“Symptoms of Urinary Tract Infections in Older Adults,” Cleveland Clinic, last accessed June 8, 2023,
2“Symptoms of Urinary Tract Infections in Older Adults.”
3“Symptoms of Urinary Tract Infections in Older Adults.”
4Teresa A. Rowe, et. al., “Urinary tract infection in older adults,” National Library of Medicine, last accessed June 8, 2023,
5“Symptoms of Urinary Tract Infections in Older Adults.”
6Alison Gwinn, “Sneaky Signs of a UTI After 50,” AARP, last accessed June 8, 2023,
7“Sneaky Signs of a UTI After 50.”
8“Sneaky Signs of a UTI After 50.”
9“Urinary Tract Infections (UTIs) in Older Adults,” Healthline, last accessed June 8, 2023,
10“Urinary Tract Infections (UTIs) in Older Adults.”
11“Urinary Tract Infections (UTIs) in Older Adults.”
12“Urinary Tract Infections (UTIs) in Older Adults.”
13“Symptoms of Urinary Tract Infections in Older Adults.”
14“Urinary Tract Infections (UTIs) in Older Adults.”
15“Urinary Tract Infections (UTIs) in Older Adults.”
16“Urinary Tract Infections (UTIs) in Older Adults.”
17“Urinary Tract Infections (UTIs) in Older Adults.”
This information is provided for educational purposes only. It is not to be used for medical advice, diagnosis or treatment. Consult your healthcare provider if you have questions or concerns.
Humana is a Medicare Advantage HMO, PPO and PFFS organization with a Medicare contract. Humana is also a Coordinated Care plan with a Medicare contract and a contract with the state Medicaid program. Enrollment in any Humana plan depends on contract renewal.
