Urinary Tract Infections in Older Adults: Current Issues and New Therapeutic Options

Sophie Robichaud, MD, FRCP(C); Joseph M. Blondeau, MSc, PhD, RSM(CCM), SM(AAM), SM(ASCP), FCCP


Geriatrics and Aging. 2008;11(10):582-588. 

In This Article

The Older Adult Population

There is a great diversity among the older population (>65 years). A large proportion live independently in community settings (95%), others in LTC facilities (5%).[4] The epidemiology, risk factors, diagnosis, and management of UTI are affected by the different characteristics of these two populations. In the community setting, the rate of UTI accounts for 24% of all diagnosed infections, followed by respiratory tract infections.[5] The risk of infection has been mostly associated with incontinence in older women (33-50% are affected)[6] as well as the presence of cystoceles, previous surgery, increased residual urine volume, and bladder diverticuli.[7] For men, chronic urinary retention associated with prostatic hypertrophy, bacterial prostatitis, and incontinence are the principal risk factors for UTI.[3,4] Despite the fact that most of the older adults live in a community setting, the majority of studies have focused primarily on residents of LTC facilities. It is the most common infection reported in LTC facilities,[2,3,7,8] accounting for 25-30% of all bacterial infections.[8] In this particular setting, the use of chronic indwelling catheters (for 5-10% of the institutionalized population),[2,3] the presence of significant comorbidities, incontinence of both urine and bowel, and the risk of transmission of uropathogens from resident to resident[3,7,9] have been associated with both asymptomatic and symptomatic infections. Thus, the more impaired or frail the individual, the higher the risk for a symptomatic or asymptomatic UTI. It is of note that, as in the general population, women >65 years old experience symptomatic UTI more frequently than do men.[7,10]


Comments on Medscape are moderated and should be professional in tone and on topic. You must declare any conflicts of interest related to your comments and responses. Please see our Commenting Guide for further information. We reserve the right to remove posts at our sole discretion.