Sepsis and Aging

Sepsis can and does affect people of all ages. The very young (infants) and those who already have a chronic health problem or a compromised immune system are at higher risk of developing sepsis. But people who are aging, over 65 years old, particularly those who have health issues, are even more susceptible to sepsis than any other group. Adults age 65 years and older are 13 times more likely to be hospitalized with sepsis than adults younger than 65 and 63% of older adults 60 years and older are admitted to the ICU present with sepsis upon admission. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment.

Other findings specific to older adults include:

Sepsis, which was often called blood poisoning, is the body’s life-threatening response to infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment.

Suggested Citation:
Sepsis Alliance. Sepsis and Aging. 2023. https://www.sepsis.org/sepsisand/aging/

Updated November 13, 2023.

 

More About Aging

Risk Factors

Our immune system becomes less effective at fighting infections as we age. This results in older people contracting more infections and they can be more severe. Every infection we get means we have a risk of developing sepsis.

As well, as people age, they may develop chronic illnesses, such as diabetes, COPD, kidney disease, or heart failure. It’s not unusual to see someone with two or more chronic diseases.

Any type of infection from the flu to an infected bug bite can cause sepsis, the most common infections that trigger sepsis among older people are respiratory, such as pneumonia, or genitourinary, such as a urinary tract infection (UTI). In 2020, COVID-19 emerged as another strong risk factor for sepsis among older adults. Infections can also happen through infections in the mouth due to abscesses or other injuries, or skin sores, either from a simple skin tear because the skin may be dry or fragile, or a pressure injury from sitting in a wheelchair or lying in bed. There are many ways an infection can take hold.

It’s not always easy to spot infections among people who are aging. For example, symptoms of a UTI usually include the need to urinate frequently, burning or pain while urinating, and cloudy and foul smelling urine. For many seniors though, a change in mental status is the first sign of a UTI. They become confused or disoriented. So the infection could be present for quite a while before anyone notices. The same could happen with other infections, like pneumonia.

Since infections might not be obvious, if an older person becomes confused or behaves in an unusual manner, or if confusion or disorientation worsens, this could be a sign of an infection.

Symptoms

Signs of sepsis are generally the same among all adults, regardless of age:

  • Change in body temperature, either a fever (above 101.3 degrees F) or a lower than normal temperature (below 95 degrees F);
  • Rapid heart rate (above 90 beats per minute);
  • Rapid breathing (above 20 breaths per minute);
  • Shaking
  • Confusion, which may be more common among older people

Sepsis can move into severe sepsis quickly, so getting help and treatment as quickly as possible is vital.

Treatment

Sepsis needs to be suspected and recognized as quickly as possible. It must be treated fast. The risk of death increases every hour of delayed treatment.

Treatment is with IV fluids and antibiotics. Other medications, such as those to raise blood pressure may be needed. If someone you know is admitted to an intensive care unit (ICU), you may see many machines used to monitor various things, such as body function (heart rate, blood pressure), medications and IV fluids that are being administered, and perhaps a ventilator to help the patient breathe.

Prevention

The key to preventing sepsis is to prevent infections, especially among the aging, from occurring in the first place.

  • Many illnesses can be and are prevented through regular vaccinations, such as for the flu or pneumonia. You can learn more at Sepsis and Prevention: Vaccines.
  • The risk of getting an infection also drops with proper hand washing. Thorough, proper, and frequent hand washing with either soap and water or soapless products decrease the number of pathogens that could enter your body.
  • Reduce infections by properly caring for all wounds, even the smallest scrape or cut. A thorough cleaning with soap and water will help remove any bacteria at the wound opening.
  • Take all infections seriously. Do not hope it will go away. Act quickly.
  • Try to ensure you eat a healthy diet. Malnutrition, not consuming enough nutrients for your needs, can lower your body’s ability to fight infection.

Sepsis is a very serious illness for anyone at any age, but it can be particularly devastating for seniors. Older severe sepsis survivors are more than three times more likely to see a drop in cognitive (mental) abilities that can make it impossible for them to return to their previous living arrangements. This often results in admission into a chronic healthcare facility. As well, the risk of dying from severe sepsis or septic shock rises as you get older.

Sepsis doesn’t affect just the patient, researchers have discovered. The stress of having a family member who is so ill can take a toll on spouses or partners too, especially if they are the primary caregivers. For example, a study published in 2012 found that the wives of older sepsis survivors were at greater risk of developing depression, as much as three to four times the average. Depression can be very serious, affecting quality of life and even the ability to function independently.

Related Resources

Sepsis as you Age

Sepsis and Home Care

Information Guide

Immune System

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Information Guide

Aging

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Missy H.

What can one say about their story? I remember being so hot and so cold and came to a point where I couldn’t even get out of bed. My body had lost control. My youngest daughter called my older daughter to see if she could come over because it stank in the house. The stench was me. My daughters saved my life literally. I don’t remember much and, I was told when I was taken to the hospital they asked me my name and I didn’t know it. The first thing I do remember is the PICC line coming out ... Read Full Story

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Gerald H. Williams

Well, a year ago, I was having lower side/back pain and could hardly walk. I called doctor that asked me the level of pain out of 10. My reply was 15+. His answer was go to the clinic so I did., The doctor on duty asked me a few questions and said I had a kidney stone on the move. (Sepsis and Kidney Stones) Sent me to the hospital with a note. Upon arriving at hospital, I was immediately met and assessed and put on a bed. Off to the ultra sound and an x-ray. 20 minute later was told ... Read Full Story

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James Roberts

A little over 2 years ago it was January 12 /2019 I had gone to a friend’s for dinner and after taking off my jacket, I developed the chills. So I took some aspirin and slept it off till morning. After getting home I was still very feverish and had a very bad back ache. I spent the whole day in bed and finally ask my roommate to take me to the Emergency room where I was diagnosed with a lower lumbar strain, given some meds and sent home. That next day the pain in my back was excruciating and ... Read Full Story

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Larry W.

My husband spent 15 hours in ER at local hospital surrounded by sick covid people before being seen. Admitted with sepsis from a urinary tract infection after 20 hours of waiting. (Sepsis and UTIs) Negative PCR test. Administered morphine as pain was that bad. Loaded up with antibiotics and discharged in 36 hours or less because needed his bed for covid. Within week BP tanked, temp rose, liver and kidneys failed, heart functioning at less 20%. Doctors and specialists ignored pleas for help. Drove hour and half in horrendous rain storm to another facility begging for help. Larry coded and ... Read Full Story

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David Geddes

My dad died 24/01/2021 from urosepsis. (Sepsis and Urinary Tract Infections) Dad became paraplegic 18 months prior due to a spinal cord cavernoma. (Sepsis and Paralysis) My Dad had 2 grade 4 bed sores, one to the bone. (Sepsis and Pressure Ulcers/Injuries) He received care from community nurses daily and 2 carers 4 times a day! The carers would often forget to switch my Dad’s day catheter bag to night mode resulting in urine back tracking into my Dad! Along with this and the delay in detecting a UTI, it cost my Dad his life! I’m at the moment fighting ... Read Full Story

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Aging