In older adults, signs of a urinary tract infection may be atypical and include:

• A. Dysuria or frequency
• B. Confusion, agitation, falls
• C. Hematuria
• D. Nausea only

Answer: (B)

Older adults often don’t show the classic urinary symptoms of a UTI. The signs are frequently non-specific and may include cognitive and functional changes. Confusion, agitation, and an increased risk of falls are common atypical manifestations of infection in the elderly, reflecting delirium or overall brain and body vulnerability during infection. These signs should prompt evaluation for a urinary infection even when there isn’t clear dysuria or urinary frequency.

Dysuria or frequency are typical urinary symptoms seen in many ages, so they’re less likely to be the atypical signs the question focuses on. Hematuria can occur with UTIs but isn’t as characteristic of the atypical presentation in older adults. Nausea can accompany many illnesses and isn’t specific to the atypical pattern either.