Urinary Incontinence in Older Adults

Urinary incontinence refers to when a person leaks urine by accident. While it can happen to anyone, urinary incontinence, also known as overactive bladder, is more common in older people, especially women. Bladder control issues can be embarrassing and cause people to avoid their normal activities. But incontinence can often be stopped or controlled.

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What happens in the body to cause bladder control problems? Located in the lower abdomen, the bladder is a hollow organ that is part of the urinary system, which also includes the kidneys, ureters, and urethra. During urination, muscles in the bladder tighten to move urine into the tube-shaped urethra. At the same time, the muscles around the urethra relax and let the urine pass out of the body. When the muscles in and around the bladder don’t work the way they should, urine can leak, resulting in urinary incontinence.

Incontinence can happen for many reasons, including urinary tract infections, vaginal infection or irritation, or constipation. Some medications can cause bladder control problems that last a short time. When incontinence lasts longer, it may be due to:

• Weak bladder or pelvic floor muscles

• Overactive bladder muscles

• Damage to nerves that control the bladder from diseases such as multiple sclerosis, diabetes, or Parkinson’s disease

• Diseases such as arthritis that may make it difficult to get to the bathroom in time

• Pelvic organ prolapse, which is when pelvic organs (such as the bladder, rectum, or uterus) shift out of their normal place into the vagina or anus. When pelvic organs are out of place, the bladder and urethra are not able to work normally, which may cause urine to leak.

Most incontinence in men is related to the prostate gland. Male incontinence may be caused by:

• Prostatitis, a painful inflammation of the prostate gland

• Injury or damage to nerves or muscles from surgery

• An enlarged prostate gland, which can lead to benign prostate hyperplasia, a condition in which the prostate grows as men age

Types of urinary incontinence

There are different types of incontinence:

• Stress incontinence occurs when urine leaks as pressure is put on the bladder, such as during exercise, coughing, sneezing, laughing, or lifting heavy objects. It’s the most common type of bladder control problem in younger and middle-aged women. It also may begin later, around the time of menopause.

• Urge incontinence happens when people have a sudden need to urinate and cannot hold their urine long enough to get to the toilet. It may be a problem for people who have diabetes, Alzheimer’s disease, Parkinson’s disease, multiple sclerosis, or stroke.

• Overflow incontinence happens when small amounts of urine leak from a bladder that is always full. A man can have trouble emptying his bladder if an enlarged prostate is blocking the urethra. Diabetes and spinal cord injuries can also cause this type of incontinence.

• Functional incontinence occurs in many older people who have normal bladder control. They just have a problem getting to the toilet because of arthritis or other disorders that make it hard to move quickly.