Diagnosis and management of urinary incontinence in the older patient

Objectives: To review the various causes of urinary incontinence (UT) in el derly patients and to outline a therapeutic approach to the clinical manage ment of UI. Data Sources: Online search of MEDLINE and additional references selected f rom the articles found during the search. Study Selection: All peer-reviewed articles and review articles listed on M EDLINE published between 1966 and 1999. Key search terms included urinary i ncontinence, geriatric, aging, pelvic floor rehabilitation, and indwelling catheter. Data Extraction: Articles with clinical relevance to the geriatric populati on were selected based on the robustness of the studies and reviews. If app licable, data from studies of healthier or younger populations was extrapol ated to the elderly population examined in this review. Data Synthesis: UI is a common occurrence among older adults treated in reh abilitation settings. The causes of UI in the elderly vary, including trans ient causes, established pathologic states of the urinary tract, and system ic multifactorial influences. Both behavioral and pharmacologic management strategies can successfully be implemented for UI, even in the frail elderl y. Conclusion: UI can be effectively investigated and treated by rehabilitatio n practitioners by following a simple, stepwise approach.