37 Million Incontinent Seniors

July 22, 2014

A report from the National Center for Health Statistics detailing the extent of the problem of urinary incontinence in senior citizens was picked up by Judith Graham of the New York Times this week (http://newoldage.blogs.nytimes.com/2014/07/22/an-emotional-burden-rarely-discussed/?_php=true&_type=blogs&_r=0).  Data suggest that 37 million seniors who live independently suffer from incontinence of bowel or bladder.  We have long known that approximately 50% of nursing home residents are incontinent but this figure is alarming as these individuals should represent the healthiest segment of the population.  

The article is well written and there are many interesting comments.  However, one issue that is not adequately addressed is that, while incontinence is common among the elderly, it is not normal, expected, or even specifically related to age.  An excellent study by McGrother & colleagues in the UK (Age & Ageing 2006;35:16-24) showed that most of the increase in urinary incontinence is the result of other diseases.  The authors concluded that for overactive bladder (the most common bladder disorder of the elderly), "The association with old age . . . disappeared after controlling for a full range of specific comorbidities, suggesting that the condition is age related rather than age dependent."  

The lesson is that, while we can certainly treat incontinence effectively, it is better to prevent it! How?  

The key is establishing and maintaining vigorous health in the middle age years that will be carried into old age. Of course no tobacco and moderation in alcohol and caffeine.  While there are no dietary factors that strongly correlate with incontinence, a healthy diet is important to prevent vascular disease, obesity, diabetes and other conditions which do cause leakage.  It is critical to create an enjoyable exercise program and set goals--get down to your ideal body weight, improve your strength and stamina year to year.  If you do suffer from bladder problems address them early--don't wait until things are more difficult to treat.