What is the first symptom that may be noticed in an older adult with a urinary tract infection (UTI)?

Acute confusion is often the first symptom noticed in older adults with a urinary tract infection (UTI) due to several reasons. In geriatric populations, the presentation of infections can be atypical. Instead of the classic signs and symptoms often seen in younger individuals, such as dysuria or fever, older adults may exhibit sudden changes in cognitive function or behavior. This is sometimes referred to as "confusion."

This confusion can arise because older adults often have diminished physiological reserves and altered immune responses, which can make them less likely to exhibit typical symptoms. Additionally, cognitive impairment or delirium can often be the first and most notable sign of infection in this age group, sometimes without the accompanying physical symptoms that would normally prompt immediate investigation into a urinary issue. Recognizing this pattern is key for healthcare providers to ensure prompt diagnosis and treatment, ultimately preventing more severe complications associated with untreated UTIs, which are quite common in geriatric patients.