To diagnose a urinary tract infection (UTI) in an asymptomatic senior, a provider performs a urine culture to identify bacteria . While a positive dipstick may suggest bacteriuria, it has limited use in this population due to potential false positives. The key is to avoid treating asymptomatic bacteriuria, which is common in seniors and rarely requires antibiotics. Antibiotics are reserved for symptomatic patients and can increase antibiotic resistance. [ 1 , 2 , 3 , 4 , 5 ] Why is Diagnosis Tricky in Seniors? Non-specific Symptoms : Seniors, especially those with cognitive impairment, may not have typical UTI symptoms and can present with confusion, delirium, falls, or a worsening of their general condition. [ 5 , 6 ] Asymptomatic Bacteriuria : Many seniors with bacteriuria (bacteria in the urine) do not have a UTI. [ 2 , 7 ] Diagnostic Tools Urine Culture : This is the gold standard for confirming a UTI. A properly collected, midstream clean-catch or catheterized urine sample...
