Skip to main content

Advertisement

Log in

Nonsurgical Management of Urinary Incontinence in Older Women

  • Geriatric Urology (H Richter, Section Editor)
  • Published:
Current Geriatrics Reports Aims and scope Submit manuscript

Abstract

Purpose of Review

Urinary incontinence is highly prevalent and very costly. Proper detection and evaluation of urinary incontinence can facilitate appropriate treatment options for older women. Our goal is to discuss first-line, nonsurgical management of urinary incontinence in older women. We include behavioral, lifestyle, and pharmacologic management options.

Recent Findings

Behavioral treatment options represent first-line treatments and have efficacy data for all types of urinary incontinence. Behavioral treatments include pelvic floor muscle exercises, strategies for controlling stress and urgency symptoms, bladder training, and lifestyle interventions. Pharmacologic treatment options are available for urgency and mixed urinary incontinence which include antimuscarinics and β-3 adrenoreceptor agonists. Emerging data exists for vaginal estrogen use and pharmacologic treatments among frail, older women. Pharmacologic therapies have specific considerations when using in frail or cognitively impaired women who are more susceptible to adverse drug events.

Summary

Efficacious management options exist for older women with urinary incontinence. Given overall poor adherence rates to incontinence treatments among all women, older women should be monitored closely for response to management options, and referral considered when indicated.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1

Similar content being viewed by others

References

Papers of particular interest, published recently, have been highlighted as: •Of importance

  1. Haylen BT, de Ridder D, Freeman RM, Swift SE, Berghmans B, Lee J, et al. An International Urogynecological Association (IUGA)/International Continence Society (ICS) joint report on the terminology for female pelvic floor dysfunction. Neurourol Urodyn. 2010;29(1):4–20.

    PubMed  Google Scholar 

  2. Hunskaar S, Burgio K, Diokno A, Herzog AR, Hjalmas K, Lapitan MC. Epidemiology and natural history of urinary incontinence in women. Urology. 2003;62(4 Suppl 1):16–23.

    Article  PubMed  Google Scholar 

  3. Erekson EA, Cong X, Townsend MK, Ciarleglio MM. Ten-year prevalence and incidence of urinary incontinence in older women: a longitudinal analysis of the health and retirement study. J Am Geriatr Soc. 2016;64(6):1274–80.

    Article  PubMed  Google Scholar 

  4. Landefeld CS, Bowers BJ, Feld AD, Hartmann KE, Hoffman E, Ingber MJ, et al. National Institutes of Health state-of-the-science conference statement: prevention of fecal and urinary incontinence in adults. Ann Intern Med. 2008;148(6):449–58.

    Article  PubMed  Google Scholar 

  5. Bogner HR, Gallo JJ, Swartz KL, Ford DE. Anxiety disorders and disability secondary to urinary incontinence among adults over age 50. Int J Psychiatry Med. 2002;32(2):141–54.

    Article  PubMed  PubMed Central  Google Scholar 

  6. Melville JL, Walker E, Katon W, Lentz G, Miller J, Fenner D. Prevalence of comorbid psychiatric illness and its impact on symptom perception, quality of life, and functional status in women with urinary incontinence. Am J Obstet Gynecol. 2002;187(1):80–7.

    Article  PubMed  Google Scholar 

  7. Bedretdinova D, Fritel X, Zins M, Ringa V. The effect of urinary incontinence on health-related quality of life: is it similar in men and women? Urology. 2016;91:83–9.

    Article  PubMed  Google Scholar 

  8. Milsom I, Coyne KS, Nicholson S, Kvasz M, Chen CI, Wein AJ. Global prevalence and economic burden of urgency urinary incontinence: a systematic review. Eur Urol. 2014;65(1):79–95.

    Article  PubMed  Google Scholar 

  9. Boronat-Garrido X, Kottner J, Schmitz G, Lahmann N. Incontinence-associated dermatitis in nursing homes: prevalence, severity, and risk factors in residents with urinary and/or fecal incontinence. J Wound Ostomy Continence Nurs. 2016;43(6):630–5.

    Article  PubMed  Google Scholar 

  10. Temml C, Haidinger G, Schmidbauer J, Schatzl G, Madersbacher S. Urinary incontinence in both sexes: prevalence rates and impact on quality of life and sexual life. Neurourol Urodyn. 2000;19(3):259–71.

    Article  CAS  PubMed  Google Scholar 

  11. Brown JS, Vittinghoff E, Wyman JF, Stone KL, Nevitt MC, Ensrud KE, et al. Urinary incontinence: does it increase risk for falls and fractures? Study of Osteoporotic Fractures Research Group. J Am Geriatr Soc. 2000;48(7):721–5.

    Article  CAS  PubMed  Google Scholar 

  12. Thom DH, Haan MN, Van Den Eeden SK. Medically recognized urinary incontinence and risks of hospitalization, nursing home admission and mortality. Age Ageing. 1997;26(5):367–74.

    Article  CAS  PubMed  Google Scholar 

  13. • John G, Bardini C, Combescure C, Dallenbach P. Urinary incontinence as a predictor of death: a systematic review and meta-analysis. PLoS One. 2016;11(7):e0158992. This study applies rigorous methodology to existing epidemiologic studies that evaluated the impact of urinary incontinence on mortality. The authors concluded that urinary incontinence does increase mortality when multiple studies are analyzed in aggregate.

    Article  PubMed  PubMed Central  Google Scholar 

  14. Abrams P, Andersson KE, Birder L, Brubaker L, Cardozo L, Chapple C, et al. Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn. 2010;29(1):213–40.

    Article  CAS  PubMed  Google Scholar 

  15. Wagg A, Gibson W, Ostaszkiewicz J, Johnson 3rd T, Markland A, Palmer MH, et al. Urinary incontinence in frail elderly persons: report from the 5th International Consultation on Incontinence. Neurourol Urodyn. 2015;34(5):398–406.

    Article  PubMed  Google Scholar 

  16. Burgio KL, Locher JL, Goode PS, Hardin JM, McDowell BJ, Dombrowski M, et al. Behavioral vs drug treatment for urge urinary incontinence in older women: a randomized controlled trial. JAMA. 1998;280(23):1995–2000.

    Article  CAS  PubMed  Google Scholar 

  17. Goode PS, Burgio KL, Richter HE, Markland AD. Incontinence in older women. JAMA. 2010;303(21):2172–81.

    Article  CAS  PubMed  Google Scholar 

  18. Dumoulin C, Hay-Smith EJ, Mac H-SG. Pelvic floor muscle training versus no treatment, or inactive control treatments, for urinary incontinence in women. Cochrane Database Syst Rev. 2014;5:CD005654.

    Google Scholar 

  19. Dumoulin C, Hunter KF, Moore K, Bradley CS, Burgio KL, Hagen S, et al. Conservative management for female urinary incontinence and pelvic organ prolapse review 2013: summary of the 5th International Consultation on Incontinence. Neurourol Urodyn. 2016;35(1):15–20.

    Article  PubMed  Google Scholar 

  20. • Qaseem A, Dallas P, Forciea MA, Starkey M, Denberg TD, Shekelle P, et al. Nonsurgical management of urinary incontinence in women: a clinical practice guideline from the American College of Physicians. Ann Intern Med. 2014;161(6):429–40. This clinical practice guideline utilized strong methodology to review the evidence on nonsurgical management of urinary incontinence in women. Recommendations are provided for behavioral treatments and pharmacologic treatments according to incontinence types. However, the guideline did not specifically look at management of urinary incontinence in older women.

    Article  PubMed  Google Scholar 

  21. Herderschee R, Hay-Smith EJ, Herbison GP, Roovers JP, Heineman MJ. Feedback or biofeedback to augment pelvic floor muscle training for urinary incontinence in women. Cochrane Database Syst Rev. 2011;7:CD009252.

    Google Scholar 

  22. Burgio KL, Goode PS, Locher JL, Umlauf MG, Roth DL, Richter HE, et al. Behavioral training with and without biofeedback in the treatment of urge incontinence in older women: a randomized controlled trial. JAMA. 2002;288(18):2293–9.

    Article  PubMed  Google Scholar 

  23. Burns PA, Pranikoff K, Nochajski TH, Hadley EC, Levy KJ, Ory MG. A comparison of effectiveness of biofeedback and pelvic muscle exercise treatment of stress incontinence in older community-dwelling women. J Gerontol. 1993;48(4):M167–74.

    Article  CAS  PubMed  Google Scholar 

  24. Parker WP, Griebling TL. Nonsurgical treatment of urinary incontinence in elderly women. Clin Geriatr Med. 2015;31(4):471–85.

    Article  PubMed  Google Scholar 

  25. Wallace SA, Roe B, Williams K, Palmer M. Bladder training for urinary incontinence in adults. Cochrane Database Syst Rev. 2004;1:CD001308.

    Google Scholar 

  26. Fantl JA, Wyman JF, McClish DK, Harkins SW, Elswick RK, Taylor JR, et al. Efficacy of bladder training in older women with urinary incontinence. JAMA. 1991;265(5):609–13.

    Article  CAS  PubMed  Google Scholar 

  27. Imamura M, Williams K, Wells M, McGrother C. Lifestyle interventions for the treatment of urinary incontinence in adults. Cochrane Database Syst Rev 2015(12):CD003505.

  28. Subak LL, Wing R, West DS, Franklin F, Vittinghoff E, Creasman JM, et al. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med. 2009;360(5):481–90.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  29. Wing RR, Creasman JM, West DS, Richter HE, Myers D, Burgio KL, et al. Improving urinary incontinence in overweight and obese women through modest weight loss. Obstet Gynecol. 2010;116(2 Pt 1):284–92.

    Article  PubMed  PubMed Central  Google Scholar 

  30. Wing RR, West DS, Grady D, Creasman JM, Richter HE, Myers D, et al. Effect of weight loss on urinary incontinence in overweight and obese women: results at 12 and 18 months. J Urol. 2010;184(3):1005–10.

    Article  PubMed  PubMed Central  Google Scholar 

  31. Dowd TT, Campbell JM, Jones JA. Fluid intake and urinary incontinence in older community-dwelling women. J Community Health Nurs. 1996;13(3):179–86.

    Article  CAS  PubMed  Google Scholar 

  32. Gleason JL, Richter HE, Redden DT, Goode PS, Burgio KL, Markland AD. Caffeine and urinary incontinence in US women. Int Urogynecol J. 2013;24(2):295–302.

    Article  PubMed  Google Scholar 

  33. Jura YH, Townsend MK, Curhan GC, Resnick NM, Grodstein F. Caffeine intake, and the risk of stress, urgency and mixed urinary incontinence. J Urol. 2011;185(5):1775–80.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  34. Tomlinson BU, Dougherty MC, Pendergast JF, Boyington AR, Coffman MA, Pickens SM. Dietary caffeine, fluid intake and urinary incontinence in older rural women. Int Urogynecol J Pelvic Floor Dysfunct. 1999;10(1):22–8.

    Article  CAS  PubMed  Google Scholar 

  35. Bryant CM, Dowell CJ, Fairbrother G. Caffeine reduction education to improve urinary symptoms. Br J Nurs. 2002;11(8):560–5.

    Article  PubMed  Google Scholar 

  36. Goode PS, Burgio KL, Locher JL, Umlauf MG, Lloyd LK, Roth DL. Urodynamic changes associated with behavioral and drug treatment of urge incontinence in older women. J Am Geriatr Soc 2002;50(5):808–816.

  37. Johnson 2nd TM, Burgio KL, Redden DT, Wright KC, Goode PS. Effects of behavioral and drug therapy on nocturia in older incontinent women. J Am Geriatr Soc. 2005;53(5):846–50.

    Article  PubMed  Google Scholar 

  38. Gormley EA, Lightner DJ, Faraday M, Vasavada SP, American Urological A, Society of Urodynamics FPM. Diagnosis and treatment of overactive bladder (non-neurogenic) in adults: AUA/SUFU guideline amendment. J Urol. 2015;193(5):1572–80.

    Article  PubMed  Google Scholar 

  39. Frank C, Szlanta A. Office management of urinary incontinence among older patients. Can Fam Physician. 2010;56(11):1115–20.

    PubMed  PubMed Central  Google Scholar 

  40. Andersson KE. Antimuscarinic mechanisms and the overactive detrusor: an update. Eur Urol. 2011;59(3):377–86.

    Article  CAS  PubMed  Google Scholar 

  41. Chapple CR, Khullar V, Gabriel Z, Muston D, Bitoun CE, Weinstein D. The effects of antimuscarinic treatments in overactive bladder: an update of a systematic review and meta-analysis. Eur Urol. 2008;54(3):543–62.

    Article  CAS  PubMed  Google Scholar 

  42. Samuelsson E, Odeberg J, Stenzelius K, Molander U, Hammarstrom M, Franzen K, et al. Effect of pharmacological treatment for urinary incontinence in the elderly and frail elderly: a systematic review. Geriatr Gerontol Int. 2015;15(5):521–34.

    Article  PubMed  Google Scholar 

  43. Madhuvrata P, Cody JD, Ellis G, Herbison GP, Hay-Smith EJ. Which anticholinergic drug for overactive bladder symptoms in adults. Cochrane Database Syst Rev. 2012;1:CD005429.

    PubMed  Google Scholar 

  44. Kessler TM, Bachmann LM, Minder C, Lohrer D, Umbehr M, Schunemann HJ, et al. Adverse event assessment of antimuscarinics for treating overactive bladder: a network meta-analytic approach. PLoS One. 2011;6(2):e16718.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  45. McCrea GL, Miaskowski C, Stotts NA, Macera L, Varma MG. Pathophysiology of constipation in the older adult. World journal of gastroenterology : WJG. 2008;14(17):2631–8.

    Article  PubMed  PubMed Central  Google Scholar 

  46. Wagg A, Nitti VW, Kelleher C, Castro-Diaz D, Siddiqui E, Berner T. Oral pharmacotherapy for overactive bladder in older patients: mirabegron as a potential alternative to antimuscarinics. Curr Med Res Opin. 2016;32(4):621–38.

    Article  CAS  PubMed  Google Scholar 

  47. Foote J, Glavind K, Kralidis G, Wyndaele JJ. Treatment of overactive bladder in the older patient: pooled analysis of three phase III studies of darifenacin, an M3 selective receptor antagonist. Eur Urol. 2005;48(3):471–7.

    Article  PubMed  Google Scholar 

  48. Eskandar OS, Eckford SD, Whittaker KW. Treatment of overactive bladder (OBA) with anti-cholinergic drugs and the risk of glaucoma. J Obstet Gynaecol. 2005;25(5):419–21.

    Article  CAS  PubMed  Google Scholar 

  49. • Gray SL, Anderson ML, Dublin S, Hanlon JT, Hubbard R, Walker R, et al. Cumulative use of strong anticholinergics and incident dementia: a prospective cohort study. JAMA Intern Med. 2015;175(3):401–7. This study utilized health care data from electronic medical records of an insured population to evaluate the impact of strong anticholinergic medications on new onset dementia over a 10-year period. Cumulative use of anticholinergic medications was associated with increased rates of new onset dementia and Alzheimer’s dementia.

    Article  PubMed  PubMed Central  Google Scholar 

  50. Sink KM, Thomas J, Xu H, Craig B, Kritchevsky S, Sands LP. Dual use of bladder anticholinergics and cholinesterase inhibitors: long-term functional and cognitive outcomes. J Am Geriatr Soc. 2008;56(5):847–53.

    Article  PubMed  PubMed Central  Google Scholar 

  51. Lipton RB, Kolodner K, Wesnes K. Assessment of cognitive function of the elderly population: effects of darifenacin. J Urol. 2005;173(2):493–8.

    Article  PubMed  Google Scholar 

  52. Kay G, Crook T, Rekeda L, Lima R, Ebinger U, Arguinzoniz M, et al. Differential effects of the antimuscarinic agents darifenacin and oxybutynin ER on memory in older subjects. Eur Urol. 2006;50(2):317–26.

    Article  CAS  PubMed  Google Scholar 

  53. Malhotra B, Gandelman K, Sachse R, Wood N, Michel MC. The design and development of fesoterodine as a prodrug of 5-hydroxymethyl tolterodine (5-HMT), the active metabolite of tolterodine. Curr Med Chem. 2009;16(33):4481–9.

    Article  CAS  PubMed  Google Scholar 

  54. Wagg A, Khullar V, Marschall-Kehrel D, Michel MC, Oelke M, Darekar A, et al. Flexible-dose fesoterodine in elderly adults with overactive bladder: results of the randomized, double-blind, placebo-controlled study of fesoterodine in an aging population trial. J Am Geriatr Soc. 2013;61(2):185–93.

    Article  PubMed  Google Scholar 

  55. • Dubeau CE, Kraus SR, Griebling TL, Newman DK, Wyman JF, Johnson 2nd TM, et al. Effect of fesoterodine in vulnerable elderly subjects with urgency incontinence: a double-blind, placebo controlled trial. J Urol. 2014;191(2):395–404. This clinical trial specifically evaluated the efficacy and safety of using fesoterodine for urgency urinary incontinence in older women and men with comorbidities and functional impairments.

    Article  CAS  PubMed  Google Scholar 

  56. Sand PK, Johnson Ii TM, Rovner ES, Ellsworth PI, Oefelein MG, Staskin DR. Trospium chloride once-daily extended release is efficacious and tolerated in elderly subjects (aged ≥75 years) with overactive bladder syndrome. BJU Int. 2011;107(4):612–20.

    Article  PubMed  Google Scholar 

  57. Staskin D, Kay G, Tannenbaum C, Goldman HB, Bhashi K, Ling J, et al. Trospium chloride has no effect on memory testing and is assay undetectable in the central nervous system of older patients with overactive bladder. Int J Clin Pract. 2010;64(9):1294–300.

    Article  CAS  PubMed  Google Scholar 

  58. Layton D, Pearce GL, Shakir SA. Safety profile of tolterodine as used in general practice in England: results of prescription-event monitoring. Drug Saf. 2001;24(9):703–13.

    Article  CAS  PubMed  Google Scholar 

  59. Benner JS, Nichol MB, Rovner ES, Jumadilova Z, Alvir J, Hussein M, et al. Patient-reported reasons for discontinuing overactive bladder medication. BJU Int. 2010;105(9):1276–82.

    Article  PubMed  Google Scholar 

  60. Tyagi P, Tyagi V. Mirabegron, a beta(3)-adrenoceptor agonist for the potential treatment of urinary frequency, urinary incontinence or urgency associated with overactive bladder. IDrugs : the investigational drugs journal. 2010;13(10):713–22.

    CAS  PubMed  Google Scholar 

  61. Wagg A, Cardozo L, Nitti VW, Castro-Diaz D, Auerbach S, Blauwet MB, et al. The efficacy and tolerability of the beta3-adrenoceptor agonist mirabegron for the treatment of symptoms of overactive bladder in older patients. Age Ageing. 2014;43(5):666–75.

    Article  PubMed  Google Scholar 

  62. Rosa GM, Ferrero S, Nitti VW, Wagg A, Saleem T, Chapple CR. Cardiovascular safety of beta3-adrenoceptor agonists for the treatment of patients with overactive bladder syndrome. Eur Urol. 2016;69(2):311–23.

    Article  CAS  PubMed  Google Scholar 

  63. Weber MA, Kleijn MH, Langendam M, Limpens J, Heineman MJ, Roovers JP. Local oestrogen for pelvic floor disorders: a systematic review. PLoS One. 2015;10(9):e0136265.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  64. Cody JD, Jacobs ML, Richardson K, Moehrer B, Hextall A. Oestrogen therapy for urinary incontinence in post-menopausal women. Cochrane Database Syst Rev. 2012;10:CD001405.

    PubMed  Google Scholar 

  65. Lethaby A, Ayeleke RO, Roberts H. Local oestrogen for vaginal atrophy in postmenopausal women. Cochrane Database Syst Rev. 2016;8:CD001500.

    Google Scholar 

  66. Miller JM, Ashton-Miller JA, DeLancey JO. A pelvic muscle precontraction can reduce cough-related urine loss in selected women with mild SUI. J Am Geriatr Soc. 1998;46(7):870–4.

    Article  CAS  PubMed  Google Scholar 

  67. Goode PS, Burgio KL, Locher JL, Roth DL, Umlauf MG, Richter HE, et al. Effect of behavioral training with or without pelvic floor electrical stimulation on stress incontinence in women: a randomized controlled trial. JAMA 2003;290(3):345–352.

  68. Aksac B, Aki S, Karan A, Yalcin O, Isikoglu M, Eskiyurt N. Biofeedback and pelvic floor exercises for the rehabilitation of urinary stress incontinence. Gynecol Obstet Investig. 2003;56(1):23–7.

    Article  Google Scholar 

  69. Kim H, Suzuki T, Yoshida Y, Yoshida H. Effectiveness of multidimensional exercises for the treatment of stress urinary incontinence in elderly community-dwelling Japanese women: a randomized, controlled, crossover trial. J Am Geriatr Soc. 2007;55(12):1932–9.

    Article  PubMed  Google Scholar 

  70. Sherburn M, Bird M, Carey M, Bo K, Galea MP. Incontinence improves in older women after intensive pelvic floor muscle training: an assessor-blinded randomized controlled trial. Neurourol Urodyn. 2011;30(3):317–24.

    Article  PubMed  Google Scholar 

  71. Rogers RG. Clinical practice. Urinary stress incontinence in women. N Engl J Med. 2008;358(10):1029–36.

    Article  CAS  PubMed  Google Scholar 

  72. Richter HE, Burgio KL, Brubaker L, Nygaard IE, Ye W, Weidner A, et al. Continence pessary compared with behavioral therapy or combined therapy for stress incontinence: a randomized controlled trial. Obstet Gynecol. 2010;115(3):609–17.

    Article  PubMed  PubMed Central  Google Scholar 

  73. Kenton K, Barber M, Wang L, Hsu Y, Rahn D, Whitcomb E, et al. Pelvic floor symptoms improve similarly after pessary and behavioral treatment for stress incontinence. Female Pelvic Med Reconstr Surg. 2012;18(2):118–21.

    Article  PubMed  PubMed Central  Google Scholar 

  74. Lipp A, Shaw C, Glavind K. Mechanical devices for urinary incontinence in women. Cochrane Database Syst Rev. 2014;12:CD001756.

    Google Scholar 

  75. Li J, Yang L, Pu C, Tang Y, Yun H, Han P. The role of duloxetine in stress urinary incontinence: a systematic review and meta-analysis. Int Urol Nephrol. 2013;45(3):679–86.

    Article  CAS  PubMed  Google Scholar 

  76. Viktrup L, Yalcin I. Duloxetine treatment of stress urinary incontinence in women: effects of demographics, obesity, chronic lung disease, hypoestrogenism, diabetes mellitus, and depression on efficacy. Eur J Obstet Gynecol Reprod Biol. 2007;133(1):105–13.

    Article  CAS  PubMed  Google Scholar 

  77. Schagen van Leeuwen JH, Lange RR, Jonasson AF, Chen WJ, Viktrup L. Efficacy and safety of duloxetine in elderly women with stress urinary incontinence or stress-predominant mixed urinary incontinence. Maturitas. 2008;60(2):138–47.

    Article  CAS  PubMed  Google Scholar 

  78. Diokno AC, Sampselle CM, Herzog AR, Raghunathan TE, Hines S, Messer K, et al. Prevention of urinary incontinence by behavioral modification program: a randomized, controlled trial among older women in the community. J Urol. 2004;171(3):1165–71.

    Article  PubMed  Google Scholar 

  79. Eustice S, Roe B, Paterson J. Prompted voiding for the management of urinary incontinence in adults. Cochrane Database Syst Rev. 2000;2:CD002113.

    Google Scholar 

  80. Ostaszkiewicz J, Johnston L, Roe B. Timed voiding for the management of urinary incontinence in adults. Cochrane Database Syst Rev. 2004;1:CD002802.

    Google Scholar 

  81. By the American Geriatrics Society Beers Criteria Update Expert P. American Geriatrics Society 2015 updated Beers Criteria for potentially inappropriate medication use in older adults. J Am Geriatr Soc. 2015;63(11):2227–46.

    Article  Google Scholar 

  82. Lu CJ, Tune LE. Chronic exposure to anticholinergic medications adversely affects the course of Alzheimer disease. Am J Geriatr Psychiatry. 2003;11(4):458–61.

    Article  PubMed  Google Scholar 

  83. Salahudeen MS, Duffull SB, Nishtala PS. Anticholinergic burden quantified by anticholinergic risk scales and adverse outcomes in older people: a systematic review. BMC Geriatr. 2015;15:31.

    Article  PubMed  PubMed Central  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Alayne D. Markland.

Ethics declarations

Conflict of Interest

Jubilee Tan and Alayne Markland declare no conflict of interest.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.

Additional information

This article is part of the Topical Collection on Geriatric Urology

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Tan, J., Markland, A.D. Nonsurgical Management of Urinary Incontinence in Older Women. Curr Geri Rep 6, 54–63 (2017). https://doi.org/10.1007/s13670-017-0200-6

Download citation

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s13670-017-0200-6

Keywords

Navigation