Urinary incontinence increases with age and activities of daily living (ADLs) dependence, affecting up to 30 percent of all orders more than 65 years old and up to 70 percent of all long-term care residents. There are four main types of urinary incontinence in older adults, urgency incontinence, stress incontinence, mixed incontinence and incontinence associated with incomplete bladder emptying also known as overflowing incontinence.

Most commonly, patients between 65 and 75 years of age have mixed urinary incontinence and women more than 75 years of age have urgency incontinence. Obesity is the strongest risk factor for unit incontinence closely followed by functional impairment, dementia, multiple medications, diabetes, environmental barriers to toilet access.

Some of the common medications causing urinary incontinence include medications taken for high blood pressure, medications taken for depression or anxiety, medications taken for diabetes. Three common screening questions to be asked will include: “Do you have any problems with urinating?” “Do you have any problems making it to the bathroom on time?” and “Do you ever leak or lose urine?”

Best early management of unity incontinence includes weight loss, quitting smoking and alcohol drinking, behavioral therapies like pelvic floor muscle exercises involving kegels exercises. Another important aspect of management is bladder training involving time dividing or prompted voiding to help prevent accidents. medications can also be used but it depends on a case-to-case basis, depending on patients other existing comorbidities. In severe cases, surgery can also be an option.

Anyone who would like to ask me a medical question relating to the health of older adults can email me at questions@apexmedicalgroup.org. I hope to provide a helpful answer in a future issue of this newspaper.

Disclaimer: The information shared in this column is based on current practice guidelines but is not intended to be a substitute for professional medical advice, diagnosis or treatment. Always seek the advice of your healthcare provider with any questions regarding a medical condition.

Dr. Arvindselvan Mohanaselvan, M.D.

Dr. Arvindselvan Mohanaselvan, M.D., is a physician board certified in internal medicine, with a subspecialty in geriatrics. He currently works at Apex Medical Group as a primary care and geriatric medicine provider. Email questions for Paging the Doctor on Call to questions@apexmedicalgroup.org.