Urinary tract infections (UTIs) in the elderly (people over age 80), are caused by several factors that increase their susceptibility. These include:

Bacterial Infections

Escherichia coli (E. coli): The most common bacteria that causes UTIs, accounting for the majority of cases.

Other Bacteria: Other common pathogens include Proteus, Klebsiella, Enterococcus, and Pseudomonas species.

Weakened Immune System: Aging can lead to a decline in immune function, making it harder to fight off infections.

Age-Related Changes

Postmenopausal Changes: UTIs in older and elderly women become more frequent after menopause.  Decreased estrogen levels can lead to changes in the vaginal flora, reducing the number of protective lactobacilli and increasing susceptibility to UTIs.  Read more about how menopause causes UTIs at Understanding UTIs.

Prostatic Enlargement: In men, an enlarged prostate gland (a condition known as benign prostatic hyperplasia or BPH) can obstruct urine flow, leading to incomplete bladder emptying causing bacterial growth in the urine.  Read more about how prostate issues cause UTIs at Understanding UTIs.

Changes in the Urinary Tract: The bladder and urinary tract can lose some of their elasticity and function, leading to incomplete emptying of the bladder.

Chronic Health Conditions

Diabetes: Higher blood sugar levels can promote bacterial growth and impair immune response.

Neurological Disorders: Conditions like Parkinson’s disease, Alzheimer’s disease, and stroke can affect bladder control and increase UTI risk.

Dehydration: Inadequate fluid intake can lead to less frequent urination, allowing bacteria to multiply in the bladder.

Incontinence: Both urinary and fecal incontinence can increase the risk of bacterial contamination of the urinary tract.

Use of Catheters

Indwelling Catheters: Long-term use of urinary catheters provides a direct pathway for bacteria to enter the bladder.

Intermittent Catheterization: Even intermittent catheter use can increase the risk of introducing bacteria into the urinary tract.

Hospitals and Long-Term Care Facilities

Healthcare Settings: Being in a hospital, assisted-living or skilled nursing facility increases exposure to multi-drug resistant bacteria and increases the likelihood of catheter use.

Preventative measures, such as proper hydration, good hygiene, careful management of chronic conditions, and judicious use of catheters, can help reduce the incidence of UTIs in the elderly.

How To Treat and Prevent UTIs In The Elderly

Antibiotics Resistance Limits Treatment

Recurrent UTIs are common among elderly female and male patients.  The first line of UTI treatment for the elderly is a course of oral antibiotics.  

Because antibiotics have been so over-prescribed, most older patients have become “antibiotic resistant”.  There are only two oral antibiotics which remain effective against UTIs.  Read more about antibiotics resistance at Understanding UTIs.

Doctors Can No Longer Prescribe Antibiotics for Prevention

The American Medical Association has recently issued guidance on UTI prevention for the elderly: doctors are no longer permitted to prescribe long-term antibiotics as a preventative against recurring UTIs due to the serious side effects they caused in older women and men. 

Natural Alternatives Are Now Being Recommended

The good news is that there are two all-natural alternatives which have been proven effective in both treating and preventing UTIs in the elderly females and males.

1.      D-Mannose powder which binds to the UTI bacteria and flushes them out of the bladder.  This supplement can be used to treat an active UTI and provide relief from symptoms; it can also be used as a daily UTI preventative.  A March 2022 article in Antibiotics Magazine confirmed that D-Mannose is as effective as antibiotics in the treatment of ­­­­­­­­­­­­­­­­­­­­­­­­uncomplicated urinary tract infections.

2.      Cranberry Extract capsules which deliver a daily dose pf 36 mg. of proanthocyandins (PACs) prevents bacteria from sticking to the bladder lining and starting an infection.  A November 2019 article in Today’s Geriatric Magazine confirmed that 36 mg of PAC was as effective as the antibiotic trimethoprim in preventing recurring UTIs in the elderly.

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