Urinary incontinence management in geriatric patients

Abstract

Objective: To review prevalence, causes, types, and appropriate therapy to treat urinary incontinence (UI) in geriatric patients.

Data sources: Selection and extraction from a PubMed/MEDLINE, English-language literature search from 2000 to the present using the search terms urinary incontinence and geriatrics.

Data synthesis: UI is a prevalent condition in geriatric patients. Unmanaged UI decreases quality of life and increases the risk of perineal skin breakdown, which can lead to painful skin irritation and pressure sores. Identifying the type of UI, and treating or eliminating transient causes as a result of acute conditions or medications, are initial steps in appropriate management. Health professionals can identify medication-related causes by reviewing the patient history, diagnoses, symptoms, and medication regimen. Chronic UI is often caused by physiological changes in the bladder; increasing age also can result in changes in bladder and urethral compliance. Other UI risk factors include impaired function, cognition, mobility, and dexterity as well as neurodegenerative damage that affect the patient's ability to toilet or recognize the need to toilet. Chronic or persistent UI is classified as stress, urge, overflow, functional, or mixed. Treatment options for chronic UI are discussed in detail.

Conclusion: Pharmacists can have a positive impact on this condition by recommending appropriate medication changes and pharmacologic and nonpharmacologic treatments.