Diagnosis and management of urinary incontinence in the older patient

Objectives: To review the various causes of urinary incontinence (UT) in elderly patients and to outline a therapeutic approach to the clinical management of UI. Data Sources: Online search of MEDLINE and additional references selected from the articles found during the search. Study Selection: All peer-reviewed articles and review articles listed on MEDLINE published between 1966 and 1999. Key search terms included urinary incontinence, geriatric, aging, pelvic floor rehabilitation, and indwelling catheter. Data Extraction: Articles with clinical relevance to the geriatric population were selected based on the robustness of the studies and reviews. If applicable, data from studies of healthier or younger populations was extrapolated to the elderly population examined in this review. Data Synthesis: UI is a common occurrence among older adults treated in rehabilitation settings. The causes of UI in the elderly vary, including transient causes, established pathologic states of the urinary tract, and systemic multifactorial influences. Both behavioral and pharmacologic management strategies can successfully be implemented for UI, even in the frail elderly. Conclusion: UI can be effectively investigated and treated by rehabilitation practitioners by following a simple, stepwise approach.