Urinary incontinence occurs whenever a person unintentionally passes urine. According to the American Society of Consultant Pharmacists (ASCP), as many as 15 to 35 percent of people over the age of 60 may suffer from urinary incontinence, and "women are twice as likely as men to suffer from the condition." Urinary incontinence is severe enough in many elderly people that they must remain in their homes, and more than half of the patients admitted to nursing facilities are admitted with a medical diagnosis of incontinence. There are many known causes for urinary incontinence.
Normal Aging
As people age, according to the ASCP, "changes in urinary tract physiology ... can affect continence." The bladder loses elasticity and requires frequent emptying. The bladder wall (detrusor) muscles lose strength and may impede complete emptying, or the walls may contract involuntarily and create an inability to hold urine in the bladder. Fluid volume in the bladder also increases due to lessening ability to produce concentrated urine. Postmenopausal women suffer declining efficiency of the urethral sphincters (due indirectly to estrogen deficiency), as well as loss of strength in the pelvic floor muscles.
Physical Disorders
According to the Merck Manual of Geriatrics, "Continence requires input from the central nervous system (CNS).... The role of the CNS is complex and not fully understood." Stroke, dementia, tumors, meningiomas, frontal lobe aneurisms, Parkinson's disease, and other disorders affecting the CNS can have unpredictable effects on urinary activity. Incontinence can also result from urinary tract infections, atrophic urethritis or vaginitis in postmenopausal women, hyperglycemia (high blood sugar), peripheral venous insufficiency, hypoalbuminemia, or depression and other psychiatric conditions. Impacted stool can cause temporary urinary incontinence. The Indian Medlars Center identifies several other pertinent disorders, including prostatic hypertrophy (benign or malignant), urethral stricture, cystocoele, uterine prolapse in women, multiple sclerosis, spinal cord lesions and diverticulitis.
Drug Side Effects
The ASCP website listed below provides a comprehensive list of prescription drugs that may cause incontinence. These include sympathomimetic decongestants; alpha-adrenergic antagonists such asprazosin, terazosin and phenoxybenzamine; anticholinergics; antipsychotics (neuroleptics); bromocriptine; calcium-channel blockers; clonazepam; diuretics; ethanol; lithium; metoclopramide; misoprostol; phenytoin; sedatives (hypnotics); skeletal muscle relaxants such as Baclofen or Dantrolene; and sympatholytics such as methyldopa, reserpine, or guanethedine.
Behavioral Factors
According to the Merck Manual of Geriatrics, alcohol and drug use frequently cause episodes of incontinence in the elderly. High intake of caffeine or other diuretics have the same effect. A sedentary lifestyle also promotes incontinence.
