UTI Archives - Better Health While Aging

Q&A: How to Prevent, Detect, & Treat Dehydration in Aging Adults

Q: How can we get my older mother to drink more water? She is susceptible to urinary tract infections and seems to be often dehydrated no matter what we do. We were also wondering if coffee and tea are okay, or should they be avoided to reduce dehydration? And what are symptoms of dehydration in older women that we can look out for?

A: Dehydration is indeed an important problem for older adults. It can be common even when it’s not hot outside.

Helping an older person increase her fluid intake, as you’re trying to do, is one of the best ways to reduce the risk of dehydration.

Now how to actually do this? Studies — and practical experience — suggest that the best approaches include:

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Urinary Incontinence in Aging:
What to know when you can’t wait to go

by Nicole Didyk, MD

“I know where every bathroom is at the mall, and my wife rolls her eyes every time I have to visit one when we just arrived – even after I went before leaving the house! What can I expect? Most old guys are in the same boat!”

If you opened this article, you probably relate to the quote above, and you’re not unlike millions of other older adults.

Incontinence doesn’t always mean wetting yourself. It can involve urgent needs to use the toilet, frequent bathroom trips, or losing tiny amounts of urine with certain activities.

Incontinence is more than inconvenient; it can be life-altering, leading to early retirement or social withdrawal, depression, and loss of independent function. Important incontinence stats include:

1 in 3 older women and 1 in 12 older men have lower urinary tract symptoms that can include incontinence
Urinary incontinence cost the US economy $66 billion in 2012
6-10% of nursing home admissions are due to urinary incontinence
Only 22% of men with urinary incontinence seek help for the problem, as compared to 45% of women

For this reason, in geriatrics, we often ask our patients about incontinence.

A while back I had the opportunity to talk to Dr. Adrian Wagg, a Geriatrician-Internist and international expert in urinary incontinence. You can listen to this interview, and find out how to download a transcript of it here. In this article, I’ll share some of his insights about the management of incontinence in older adults, and why it remains undertreated too often.

In particular, I’ll cover:

How urinary function changes with age
Types and causes of urinary incontinence in both men and women
What to do if you’re experiencing urinary incontinence and want help
How to help manage urinary incontinence in an older person you’re caring for

What happens to the Urinary System with Aging?

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UTIs and Urine Bacteria in Aging:
How to get the right diagnosis & avoid unneeded antibiotics

by Leslie Kernisan, MD MPH

Q: An older friend, who is in her 90s, has been having bacteria in her urine, but no symptoms. Despite treatment with antibiotics, she was still having bacteria in the urine, so the doctor recommended chronic antibiotics and a referral to urology.

What can be done when an elderly woman has bacteria in her urine but no symptoms? Can a urology consultation help?

A: This is a great question. People often think that your friend is having a “recurring urinary tract infection (UTI)” or even a chronic UTI. But actually, you are describing something called asymptomatic bacteriuria, which means having urine bacteria without symptoms.

Every older person and family caregiver should know about asymptomatic bacteriuria. Here’s why:

It’s very common in older adults. This condition is found in an estimated 20% of women aged 80 or older, and also affects older men. The older the person, the more common it is. Asymptomatic bacteriuria is even more common in nursing homes, where it’s estimated to affect 30-50% of residents.

It’s often confused with a urinary tract infection (UTI). This can lead to unnecessary — and potentially harmful — treatment with antibiotics.

It usually does NOT need to be treated with antibiotics. As I’ll explain below, research shows that people don’t live better or longer when asymptomatic bacteriuria is treated. In fact, such treatment can be harmful: one study found that treatment increased the risk of future (real) UTIs, and increased the risk of infection with antibiotic-resistant bacteria.

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What happens to the Urinary System with Aging?

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