Considerations in the Medically Complex and Frail Elderly



Overactive bladder (OAB) and urgency urinary incontinence (UUI) in the medically complex and frail elderly are highly prevalent and are associated with significant adverse consequences in terms of quality of life and health outcomes. OAB management in this group of patients requires the treating clinician to take a broader view of the condition and its effect on the patient. The underlying physiological change in the lower urinary tract, coupled with age- and pathology-associated central nervous system changes, mean that OAB in older people appears to be more than just bladder dysfunction. Until relatively recently there was a paucity of evidence available which specifically addressed treatment in the medically complex or frail older person. Evidence is still largely restricted to cognitively intact elderly, and relevant studies on cognitively impaired persons are still lacking. This chapter discusses what evidence exists for drug treatment of OAB-UUI in the medically complex and frail and the additional factors which might need to be taken into account in order to achieve the best outcomes from treatment.


Medically complex Multimorbidity Elderly Frailty Overactive bladder urgency incontinence 


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© Springer Nature Switzerland AG 2019

Authors and Affiliations

  1. 1.Department of Medicine, University of AlbertaEdmontonCanada

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