Challenges to diagnosis and management of infections in older adults

Abstract

Infectious diseases continue to be a major cause of morbidity and mortality among adults aged 65 and older despite improvements in antibiotic therapy and vaccinations. Older adults are at increased risk for developing infections compared to younger adults because of age-associated changes in immune function, comorbidities, and repeated exposures to healthcare settings. Diagnosing infections can be challenging in older adults because common signs and symptoms of infection (e.g., fever, leukocytosis) can be absent, especially in frail adults with cognitive impairment. Pneumonia, urinary tract infection, cellulitis, and Clostridium difficile diarrheal illness are among the most common causes of infection in this age group. This chapter reviews the challenges associated with diagnosis and management of the most frequently encountered infections in older adults.