Sepsis can and does affect people of all ages. The very young 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:
- In older adults, sepsis is 1.96 times more likely to result in readmission to a hospital than non-sepsis hospitalizations.
- More than 40% of older patients have another hospitalization within three months of the initial sepsis, most commonly due to a repeat episode of sepsis or another infection.
- Nursing home residents are over 6 times more likely to present with sepsis in the emergency room than non-nursing home residents. Sepsis and Long-Term Care explains some of the issues that can increase sepsis risk.
- There are 20,000 new cases of moderate-to-severe cognitive impairment each year among the elderly, specifically caused by sepsis.
Sometimes incorrectly called blood poisoning, sepsis is the body’s often deadly response to infection or injury. Sepsis kills and disables millions and requires early suspicion and rapid treatment for survival.
Sepsis and septic shock can result from an infection anywhere in the body, such as pneumonia, influenza, or urinary tract infections. Worldwide, one-third of people who develop sepsis die. Many who do survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, organ dysfunction (organs don’t work properly), and/or amputations.
How does sepsis occur in people who are aging?
Researchers believe that as we go through the aging process, our immune system becomes less effective at fighting infections. This results in older people contracting more infections and they are more severe. Every infection we get means we have a risk of developing sepsis.
Any type of infection can cause sepsis, from the flu to an infected bug bite, but 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, a sense of urgency (you need to urinate immediately), not feeling as if you’ve emptied your bladder completely, 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.
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);
- 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.
Why is sepsis so serious for people who are aging?
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.
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 (Sepsis and Prevention)
The key to preventing sepsis is to prevent an infection, 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.
- The information here is also available as a Sepsis Information Guide, which is a downloadable format for easier printing.
Would you like to share your story about sepsis or read about others who have had sepsis? Please visit Faces of Sepsis, where you will find hundreds of stories from survivors and tributes to those who died from sepsis.
Updated June 2, 2021.