UTIs are common infections in adults, but they’re even more prevalent in older adults and those with dementia. The symptoms and complications of UTIs may also differ in this older age group.

Urinary tract infections (UTIs) are the second most common type of infection to affect older adults. They can become serious, leading to hospitalization and further health complications, including worsening dementia.

In fact, according to data from the U.S. Department of Health and Human Services, more than 551 out of 100,000 adults ages 65 years and older were hospitalized for UTIs in 2016.

UTIs can lead to serious health concerns, particularly in older adults and people with dementia. Kidney failure is possible, and more severe cases may even be fatal.

Whether you’re personally at risk for UTIs or are a loved one or caregiver of an older adult, learning more about the possible signs and symptoms of these infections can help you access potentially lifesaving treatment.

This article takes a closer look at how UTIs affect older adults and those with dementia, as well as what you can do to reduce the risk of UTI development.

UTIs are known to cause symptoms such as pain and burning during urination. You may also feel the need to urinate more often.

But older adults with or without dementia may not experience these typical symptoms of a UTI. As a result, these infections are often called “silent UTIs” in older adults.

These populations may show atypical UTI symptoms such as:

Family members and caregivers may also observe the following signs and symptoms of a UTI in an older adult:

It can be even more challenging to detect a UTI in someone who has dementia. One key clue that something may be “off” is a sudden change in behavior or worsening symptoms of dementia.

UTIs develop when bacteria enter your urethra and then your urinary tract. Sometimes, the infection can also develop in your bladder (cystitis) or kidneys (pyelonephritis).

Adults without memory problems may be able to recognize some of the classic symptoms of a UTI. But in those with dementia, differences in brain connections can make it difficult to recognize these symptoms.

Instead, a person with dementia may express the presence of a UTI in other ways, including agitation, aggression, and other behavioral changes. Confusion and withdrawal are also possible.

Age-related difficulties in identifying symptoms and increased issues with hygiene or personal care may be other reasons why UTIs affect older adults differently.

On top of all of this, older adults and those with dementia may not be able to communicate that something is wrong.

Adults in these populations may need to take antibiotics to treat a UTI. But healthcare professionals typically prescribe these medications only in symptomatic cases to reduce the risk of antibiotic resistance.

A doctor may determine that lower doses taken for longer periods of time are more appropriate, especially for recurring UTIs.

With antibiotic treatment, the infection may clear within a few days. But in the case of an upper UTI, antibiotics may be necessary for up to 14 days. Older adults and those with dementia may also need intravenous antibiotics at a hospital.

Over-the-counter pain relievers may be another treatment option if a doctor deems them appropriate.

If an adult with dementia experiences delirium associated with a UTI that doesn’t improve, antipsychotics may help treat their symptoms. As with antibiotics, a doctor might prescribe antipsychotics on only a short-term basis.

UTIs are common in older adults and in those with forms of dementia, such as Alzheimer’s disease. According to a 2022 research review, UTIs are the cause of about 25% of all hospitalizations in older adults.

While the exact statistics vary, a 2020 review noted that studies have estimated the prevalence of UTIs in older adults at anywhere from 5 out of 100 to 12.8 out of 100 cases. Adults over 85 years of age have the greatest risk.

Females of all ages have a higher risk of developing UTIs. About 50% of all females need UTI treatment at least once in their lifetime.

Incontinence is also a common issue in the later stages of Alzheimer’s. This may be a UTI symptom or may have another cause, such as medication side effects, diabetes, or an enlarged prostate gland.

The following strategies may help prevent UTIs in older adults or those with dementia:

UTIs are common in older adults and in those with dementia. Symptoms, such as delirium or changes in behavior, can happen quite suddenly.

If you’re a caretaker or family member of an older adult or an adult with dementia, it’s important to know the possible symptoms of a UTI.

Prompt treatment is important for reducing complications associated with this infection. If left untreated, a UTI may lead to serious complications such as blood poisoning, kidney failure, or worsening delirium.