Consensus document on the management of urinary incontinence in older people

Abstract

Urinary incontinence (UI), one of the geriatric giants, is a very common problem in the older person. It especially affects those with comorbidities, polypharmacy and functional impairment, physical as well cognitive, in whom the prevalence could be as high as 70–80%. Despite its very negative effects on quality of life (QOL), UI is still largely undetected and undertreated, due to different, but incomprehensible reasons. UI produces numerous negative effects on QOL in older persons. Patients’ perception of the impact of UI on their lifestyle is very important, and even mild UI could have a significant impact on QOL. Unfortunately, both detection and index consultation for UI are low, as is the percentage of older persons that receive effective treatment (about 30–50%), in spite of the valid management options available. Also, older persons are less likely than younger age groups to discuss incontinence with their physician and only about half of those with incontinence seek help for their symptoms. Geriatricians should be in the frontline of the detection and diagnosis of UI, which can be considered as the ‘Frequently Forgotten Geriatric Giant’. To this effect, a multidisciplinary European group of professionals developed this scientific document in order to present the current “state of the art” on the management of urinary incontinence in the older population. The aim of this consensus document is to increase awareness, as well as knowledge of this under-recognized geriatric syndrome, and to facilitate and improve the clinical management of older people with UI.