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Management of Urinary Incontinence in Older Adults in Rehabilitation Care Settings

  • Geriatric Rehabilitation (P Kortebein, Section Editor)
  • Published:
Current Physical Medicine and Rehabilitation Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

This review focuses on updates in the management of urinary incontinence occurring in older adult populations living with conditions frequently managed by physical medicine and rehabilitation specialists.

Recent Findings

Urinary incontinence is common among older adults who live with neurologic diseases, such as stroke, Parkinson’s disease, multiple sclerosis, and traumatic brain injury, and may be cared for in outpatient and acute rehabilitation facilities. While the evidence is growing regarding treatment strategies specific to patients with neurogenic bladder, behavioral treatment approaches may be a viable first option depending on cognitive status and mobility. Drug therapy choices should consider mechanism of action and formulation to minimize the potential for adverse effects. Minimally invasive strategies provided by continence specialists are available for refractory symptoms.

Summary

Evidence suggests a multidisciplinary approach incorporating multicomponent treatment strategies can improve common urinary symptoms among older adults in both outpatient and acute inpatient rehabilitation settings of care.

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Authors and Affiliations

  1. Birmingham/Atlanta VA GRECC, Division of General Medicine & Geriatrics, Department of Medicine, Emory University, 1670 Clairmont Road, Mailstop: 11B, Decatur, GA, 30033, USA

    Camille P. Vaughan

  2. Department of Obstetrics and Gynecology, Department of Orthopedics and Rehabilitation, Division Female Pelvic Medicine and Reconstructive Surgery, Loyola University Chicago Stritch School of Medicine, 2160 S. First Avenue, Maywood, IL, 60153, USA

    Colleen M. Fitzgerald

  3. Birmingham/Atlanta VA GRECC, Division of Gerontology, Geriatrics & Palliative Care, Department of Medicine, University of Alabama at Birmingham, 700 South 19th Street, Mailstop: 11G, Room 8219, Birmingham, AL, 35944, USA

    Alayne D. Markland

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Correspondence to Camille P. Vaughan.

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Conflict of Interest

Camille Vaughan reports that her spouse is a full-time employee at Kimberly-Clark Corp outside the submitted work, and grant funding from the US Department of Veterans Affairs, National Institutes of Health, and the Agency for Healthcare Research & Quality. Colleen Fitzgerald reports personal fees from an UptoDate Editor, non-financial support from Board Membership with the International Pelvic Pain Society, personal fees from employment with the Loyola University Chicago Medical Center, personal fees from Expert Testimony, grants from NICHD K23 (finished in 2016), travel and registration expenses as a PAINweek lecturer, and personal fees as an editor outside the submitted work. In addition, Dr. Fitzgerald has a US Patent Application No. 14/213,880 issued. Alayne Markland declares no conflicts of interest relevant to this manuscript.

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Vaughan, C.P., Fitzgerald, C.M. & Markland, A.D. Management of Urinary Incontinence in Older Adults in Rehabilitation Care Settings. Curr Phys Med Rehabil Rep 7, 159–169 (2019). https://doi.org/10.1007/s40141-019-00221-y

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