Incontinence in the Elderly

Question 1

1. What is incontinence?

2. What contributions to incontinence are directly due to ageing?

Answer 1

1. The involuntary loss of urine.
2. Decreased bladder capacity, decreased urethral closure pressure, increased post-void residual pressure. Increased Detrusor excitability.

Question 2

1. Identify some transient causes of incontinence

Answer 2

1. Delirium
Infection – Urinary (symptomatic)
Atrophic urethritis/vaginitis
Pharmaceutical/Prostate
Psychological, especially depression
Endocrine (or excess fluid intake/output)
Restricted mobility
Stool impaction

Question 3

1. What are the five types of incontinence?

Answer 3

1. Stress, urge, mixed, functional, overflow

Question 4

Name the following types of incontinence:

1. Involuntary urinary leakage on effort or exertion, sneezing, or coughing
2. Involuntary leakage accompanied by or immediately preceded by urgency
3. Involuntary leakage associated with urgency and also with exertion, effort, sneezing, or coughing
4. Leakage owing to bladder outflow obstruction of any cause resulting in large post-void residual volume
5. Incontinence resulting from an inability to reach or use the toilet in time (for example, poor mobility, cognitive impairment)