The risk of UTIs increases with age — here's why

Urinary tract infections (UTIs) are common at any age, but older adults face a greater risk. They are among the most frequently diagnosed infections in nursing home residents and are a growing concern for seniors living independently.

As people age, UTI symptoms can become more subtle — sometimes appearing as confusion or fatigue instead of the typical burning or urgency. These less obvious signs can delay diagnosis and increase the risk of complications. Recognizing early signs and taking preventive steps can help keep elderly loved ones safe and healthy.

Why the risk grows with age

As women age and go through menopause, hormonal changes can affect the urinary tract. Dr. Prakash N. Maniam, a urologist with HCA Florida Healthcare, says the loss of estrogen alters vaginal pH, making it less acidic and more susceptible to bacterial growth. Additionally, tissues in the urethra and vagina may thin and become drier, increasing irritation and infection risk.

Age-related conditions can also make it harder for both men and women to fully empty their bladders, which can allow bacteria to linger. For men, this is often due to an enlarged prostate, while for women, it may result from conditions like uterine prolapse. Other health issues, such as multiple sclerosis or uncontrolled type 2 diabetes, can further disrupt normal bladder function.

How UTI symptoms differ in older adults

In younger adults, UTIs typically cause pain or burning during urination, frequent urges to go and general discomfort. However, in older adults, the signs can be much more subtle — and sometimes mistaken for other conditions.

For example, frequent urination or incontinence might be confused with overactive bladder, a common issue among seniors. UTIs in older adults may also present with unexpected signs, such as confusion or agitation. While confusion alone doesn’t necessarily indicate a UTI, it can be a warning sign—especially if accompanied by symptoms like lower back pain, blood in the urine, or abdominal tenderness.

Some older adults may also develop a fever over 100°F, which could suggest the infection has spread to the kidneys or upper urinary tract. Even without a fever, these symptoms should prompt medical attention.

Older adults are more at risk for complications

UTIs can lead to complications if left untreated. Dr. Maniam says a weakened immune system makes seniors more vulnerable to infections that can spread to the kidneys or bloodstream, increasing the risk of sepsis, a life-threatening condition.

If you’re unsure whether you or a loved one may have a UTI, calling a nurse is a great first step. Our free, confidential 24/7 Consult-A-Nurse® line connects you with licensed, experienced nurses who can help evaluate symptoms and guide next steps. Call 844-70-NURSE anytime.

Routine screening isn’t always necessary

Routine screening for UTIs in older adults is unnecessary unless symptoms such as fever, urinary pain, or frequent urination are present. Many seniors have bacteria in their urine without signs of infection, and unnecessary antibiotic use can cause side effects and promote antibiotic resistance2.

Older adults often provide urine samples during their annual wellness exams, but these don’t need to be screened for a UTI unless symptoms are present. Unnecessary antibiotic use can lead to side effects such as nausea, vomiting, diarrhea or vaginal yeast infections.

Preventing recurring UTIs

Recurring UTIs are common, with more than half of women over 55 experiencing another infection within a year. While cranberry juice may help, scientific evidence is inconclusive. Most experts recommend increasing water intake to help flush bacteria from the urinary tract. Good hygiene, including proper wiping and frequent changes of undergarments or adult diapers, can also play a role in preventing infections.

Postmenopausal women may benefit from vaginal estrogen treatments, available as creams, inserts, or rings, to support urinary tract health. For those prone to infections after intercourse, urinating immediately afterward can help reduce recurrence, and in some cases, healthcare providers may recommend a single low-dose antibiotic as a preventive measure.

Frequent UTIs may indicate underlying health issues, such as bladder obstruction, uterine prolapse, or kidney stones. Consulting a healthcare provider can help determine the right prevention and treatment strategies to address the individual’s needs.

Taking Charge of Your Care

Consult-A-Nurse® can assess your needs and help recommend who to see, where to go and what to do next. Call 844-70-NURSE anytime for answers, advice and peace of mind.