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Arizona Geriatric Education Center
Arizona Reynolds Program of Applied Geriatrics
Aging Pearls: Infectious Diseases
Carol L. Howe, MD, MLS, College of Medicine, University of Arizona
Did you know that “most of the common infections are associated with at least
a twofold higher death rate or more in the elderly population?”*1(p.801)
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Although the dramatically increased life expectancy of adults in the United States in
the course of the last century can be attributed to the decrease in infectious
diseases brought about by improved sanitation, antibiotics and immunizations, older
patients remain much more susceptible to severe morbidity and mortality from
infectious diseases than younger patients.
Fever, the clinical sign we most associate with infection can be absent in as many as
25% of elderly patients with serious infections such as pneumonia, sepsis,
endocarditis and meningitis.
o Older adults frequently have atypical and sometimes very subtle signs of
infection—such as mild confusion.
The most common bacterial infection in elderly patients is urinary tract infection
(UTI).
More than a third of all cases of tetanus occur in patients over the age of 60. 1
The incidence of HIV and AIDS is growing more rapidly in the ≥50 year old population
than in the under 40 age group.2
The incidence of MRSA is highest in individuals ≥ 65 years of age.3
Questions for Discussion:
1. It is important to accurately diagnose and treat all cases of asymptomatic bacteruria in
older adults living in long term care facilities to prevent the spread of urinary pathogens.
True or False? Please discuss.
2. Since the introduction of the pneumococcal vaccine, pneumonia secondary to
streptococcus pneumoniae has become very rare in the United States. True or False?
Please discuss.
3. Among HIV negative patients, the incidence of tuberculosis is highest in those aged ≥ 65.
True or false. Please discuss.
*with the exception of urinary tract infections (UTIs)
1
Yoshikawa T. Infectious diseases. In: Cassel CK. Geriatric Medicine: An Evidence-Based Approach. 4th ed. Berlin;
London: Springer; 2003:801-817.
2
Levy BR, Ding L, Lakra D, Kosteas J, Niccolai L. Older persons' exclusion from sexually transmitted disease riskreduction clinical trials. Sex Transm Dis. 2007; 34(8):541-544.
3
Klevens RM, Morrison MA, Nadle J, et al. Invasive methicillin-resistant staphylococcus aureus infections in the
united states. JAMA. 2007; 298(15):1763-1771.