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 respiratory syncytial virus (RSV), 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.

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.

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.

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.