Abstract
Urinary incontinence and lower urinary tract symptoms are highly prevalent in older adults, and are strongly associated with frailty. Despite this, frail older persons are under-represented in the research evidence and much of the management of lower urinary tract symptoms in this patient group must be based on a pragmatic extrapolation of the data from community-dwelling younger or more robust older subjects. An increasing understanding of the role of central control and the impact of cerebral white matter hyperintensities on suppression of urgency is being developed and this may have an implication for mid-life prevention. Commonly used drugs for overactive bladder are often poorly tolerated in older persons; some data for newer agents exist for the ‘medically complex’ elderly. In this article, we review the current state of knowledge and look to the future of continence management in the frail older person.
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