Who is at the greatest risk of developing urinary tract infections?
Women are at higher risk than men of developing a urinary tract infection than men because their urethra is much shorter and more exposed, making it easier for bacteria to travel up into the bladder.
There are behaviors that can put women more acutely at risk of developing a UTI (sexual activity and physical activity for example) but for some groups of people, UTIs can be even more difficult to escape and should be taken very seriously. Elderly individuals and people with diabetes are among those at highest risk of developing a UTI.
Why are these groups particularly at risk?
Reasons for Increased Risk of Infection:
The elderly are the highest risk and most vulnerable population of all to develop UTIs. There are several factors that cause this increase in risk. In general, the immune system weakens as we get older, and we become less capable of fighting off infections. As women age and go through menopause, estrogen product declines. Reduced estrogen may allow UTI causing bacteria to grow and establish themselves more easily, causing an infection.
Probably the most important factor that makes older women more likely to contract a UTI is a weakening of the muscles surrounding the bladder. On top of your natural defenses against dangerous bacteria, the pressure and force of urination can physically flush out bacteria that are both in the urine and adhering to the urinary tract wall. As we age, the muscles surrounding the bladder become weaker, making it more difficult to empty the bladder. This results in a weaker flow of urine and often leaves urine left in the bladder. This makes it easier for the bacteria to stick to the wall of the urinary tract and travel upwards into the bladder.
Catheters are used much more frequently in the elderly and are one of the most common causes of infection. A healthy urinary tract is sterile, and bacteria that come in on a catheter can cause an infection. Catheters must be regularly changed and great care must be taken to keep them sterile before use.
UTIs are Difficult to Diagnose in the Elderly:
Symptoms of UTIs in the elderly can often be very different from that of a younger person, which can make the infection difficult to diagnose. Typically, a UTI, particularly if not immediately treated, will cause a fever. A fever is a natural immune response your body launches to fight an infection. As mentioned before, the immune system weakens as we age, and often the immune system in the elderly is unable to respond to the infection with a fever.
Even more misleading for diagnoses, is that the elderly may not display any of the usual symptoms, but will show unusual symptoms that can be mistaken for dementia or Alzheimer’s. This can include confusion, drowsiness, and physical imbalance that can lead to falling. Since these symptoms can be misunderstood, it can take a long time for a UTI to be identified.
Diabetes leaves a person more vulnerable to a UTI
There are a few important reasons why those with diabetes are more likely to contract a UTI. People with diabetes may also have trouble fully emptying the bladder, which can increase risk because bacteria are able to more easily cause an infection. Neural damage can be common in those with diabetes and this can weaken the muscles responsible for emptying the bladder. Poor circulation in those with diabetes can also mean that white blood cells, the cells responsible for fighting infection, will be less able to battle the colonizing bacteria.
Jardiance (medication) significantly boosts the risk of a UTI
Jardiance is a medication for diabetes that works by filtering sugar from the blood and releasing it in the urine. The sugar in the urine makes infection more likely. This is because 1) bacteria in the urinary tract can eat this sugar and use it to grow and spread, and 2) when urine dries outside the urethra, this can make sugar available for bacteria to spread into the urinary tract. Jardiance has shown to really improve the health of those with diabetes but also comes with the unfortunate side effect of frequent urinary tract infections.
Because UTIs can escalate so quickly in these populations, they should be taken very seriously. Prevention should be the focus of any serious strategy for combatting Urinary Tract Infections.