The importance of bladder health cannot be underestimated in older adults, as many struggle with bladder conditions and diseases. Urinary tract infections can greatly impact a senior’s health. Here’s what to know about maintaining bladder health and signs of symptoms of a problem.

What is a Urinary Tract Infection (UTI)?

As a healthy, newly retired math teacher, Jean Connolly, 78, began exhibiting signs of confusion that intensified almost by the hour. A battery of emergency room tests revealed nothing out of the ordinary but a urinary tract infection. Within 48 hours of receiving her first doses of narrow-spectrum antibiotic, Connolly was back to her old self—any signs of confusion gone completely.

Symptoms of confusion or those of outright dementia that come on suddenly are not uncommon in seniors experiencing a UTI. In seniors already experiencing Alzheimer’s disease or other forms of dementia, behavior may become more erratic. Fortunately, with medication, as the UTI clears up the symptoms go away as quickly as they started, but for those who don’t make the connection it can be extremely frightening.

“One minute my healthy mother was tutoring math students—something she has done since her retirement last year,” said her daughter Julie, “and the next we were scared and perplexed, wondering if she’d had a stroke or what else could be happening to her.”

How Advancing Age Can Lead to More Frequent UTI Symptoms

As we age, elastic bladder tissue may toughen, becoming less pliant. A less flexible bladder holds less urine and causes more frequent bathroom trips. Bladder and pelvic floor muscles also weaken, which may result in incontinence. In all, chances to develop a bacterial infection increase.

UTIs are the most common bacterial infection in adults aged 65-plus, largely occurring in nursing homes where “indwelling” devices such as catheters are more common. Also, older women have lower estrogen levels following menopause. A resulting imbalance of vaginal good and bad bacteria may lead to infection.

In men, UTIs are less common due to their anatomy, but they become more susceptible if they are uncircumcised or have an enlarged prostate, known as benign prostate hyperplasia or BPH. This condition causes an inability to completely empty the bladder, where urine stagnates and thus acts as a conduit for bacteria.

If left untreated, UTIs can lead to kidney failure or sepsis –both life-threatening conditions. So what are the symptoms we should look for that may indicate a bladder problem is brewing?

Symptoms To Recognize

Among a bladder infection’s more common indicators are:

  • Frequent urge to urinate
  • Burning while urinating
  • Sensation bladder is not entirely empty
  • Pelvic or lower abdominal pain

Severe symptoms may include:

  • Intensifying abdominal pain
  • Fever
  • Chills
  • Fatigue
  • Nausea or vomiting

If you suspect you or a loved one has a bladder infection, immediately seek medical help as waiting will cause the condition to escalate quickly. To practice prevention, especially if you are prone to UTIs, the following tips located here—including fully emptying the bladder when urinating, wearing cotton underwear and loose-fitting clothing, and drinking enough fluids to continuously flush out the system—are recommended.

Urinary Incontinence

Loss of bladder control is more common than not in older Americans. The wide range of symptoms include mild bladder leakage all the way to a desire to urinate that is so strong you cannot make it to the bathroom.

Causes of urinary incontinence may vary. These include stress incontinence when you cough, sneeze, or laugh; urge incontinence which results in an involuntary loss of urine (sometimes caused by a neurological disorder or diabetes); overflow incontinence when the bladder doesn’t empty completely; functional incontinence where a mental or physical condition such as arthritis interferes with using the toilet; mixed incontinence—a combination of stress and urge incontinence. Sometimes overlooked, being overweight can put added pressure on the bladder as well, resulting in leakage, as can straining caused by frequent constipation.

There are also instances of temporary urinary incontinence. These may be caused by items that stimulate the bladder and act as diuretics such as caffeine, alcohol, chili peppers, chocolate, foods high in spice, sugar, or acid including citrus fruit; carbonated drinks and sparkling water; artificial sweeteners; heart and blood pressure medications, sedatives, and muscle relaxants.

While incontinence can’t always be prevented, experts say adding more fiber (in the case of constipation), maintaining a healthy weight, avoiding the bladder irritants listed above, and practicing pelvic floor exercises go a long way in the realm of good practices.

Overall, taking steps to maintain optimal bladder health should be part of a senior’s daily agenda. While behavioral and lifestyle changes may be necessary until a routine is established, the rewards of doing so far outweigh the effort.


“A Senior’s Guide to Bladder Infections,” written by Beth Herman, Amada blog contributor.