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Bladder infection in older adults

In older adults, a urinary tract infection (UTI) may cause usual symptoms such as burning and frequent urination, but frail people or those with dementia may show new behavioural changes. Sudden confusion has many possible causes and needs urgent assessment, rather than an assumption that it is a UTI.

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  • Older adults may have the same urinary tract infection (UTI) symptoms as younger adults: new burning when passing urine, more frequent or urgent urination, lower abdominal pain and visible blood.
  • Bacteria in urine without urinary symptoms are common in older adults. This is called asymptomatic bacteriuria and usually does not need antibiotics.
  • Cloudy or strong-smelling urine alone is not proof of infection. Dehydration, food, medicines and a catheter may change urine.
  • Sudden confusion is an urgent warning sign with many possible causes, such as dehydration, a medicine side effect, stroke, low blood sugar, pain or infection. Do not automatically assume a UTI.
  • Fever or shivering, flank pain, vomiting, low blood pressure or rapid deterioration may indicate a kidney infection or sepsis.
  • Urine dipsticks are less reliable as standalone evidence in older adults, because bacteria and white blood cells without infection are common.
  • Treatment is based on new symptoms, physical condition, urine culture, kidney function, medicines and frailty.
  • Fluids, fall risk, catheter care and medicine side effects need extra attention during recovery.

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Further reading

Browse A–Z
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Bladder infection in childrenA bladder infection in children is usually bacterial. Babies and young children may only have fever, irritability or poor feeding; older children may have burning and frequent urination. Prompt assessment helps prevent a kidney infection.
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Bladder infectionA bladder infection, or cystitis, is usually a bacterial infection of the bladder. It may cause burning when passing urine, frequent urges and lower abdominal pain; without treatment, an infection may spread up to the kidneys.
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Bladder infection in menBladder infection symptoms in men need a doctor's assessment, because a urinary tract infection (UTI) is less common and may be linked to the prostate, urinary retention, stones or another problem. A urine sample helps guide treatment.