Urinary tract infections in the elderly

Wie, Seong Heon

Abstract

The great increase in the numbers of the elderly people is one of the important challenges that our health care systems have to face and prepare. Many infectious diseases are more frequent in elderly persons, because of their decreased immune and physiologic functions. Elderly patients above the age of 65 are known to be at high risk for urinary tract infection. Urinary tract infection is the most common infection and also the first cause of bacteremia in the elderly. Most urinary tract infections in the elderly are either asymptomatic or mild and are easily managed. If left untreated, however, these infections can develop into severe and potentially life-threatening sepsis. Asymptomatic bacteriuria is neither the cause of morbidity nor associated with a higher mortality rate and thus treatment is not recommended. Older persons may not complain of typical urinary symptoms and usually have complicating factors including functional or structural abnormalities of the genitourinary tract. The epidemiology, pathogenesis, diagnosis and management of urinary tract infections in the elderly patients are discussed in this review according to their underlying diseases, sex, symptoms, and infection sites.