Causes of Elderly Incontinence

Causes of Elderly Incontinence

  • On November 28, 2017

Although people of any age can be affected by incontinence, it is much more common in elderly individuals, particularly women. It is estimated that 24% of older people in the UK are affected by urinary incontinence. 30-60% of older people in institutional care in the UK are affected by urinary incontinence, and 25% by bowel incontinence.


Incontinence in seniors can be caused by a variety of different factors.


Causes of Elderly Incontinence


Weakening of the Pelvic Floor Muscles

The process of ageing can cause a loss of muscle control and strength. If severe, this can have a negative impact on the function and structure of the lower urinary tract and pelvic floor in women. A hospital-based study by Hung et al found that the prevalence of incontinence increased significantly with advancing age. The percentage of patients with incontinence was as high as 33.3% in women when they reached the age of 65 years. The occurrence of pelvic floor dysfunction was also found to increase steadily during the ageing process. Elderly individuals, therefore, have an increased tendency towards incomplete bladder emptying, and this frequently coexists with detrusor instability. An additional series of studies conducted by Griffiths et al found that elderly patients may have under perfusion of the frontal lobes of the cerebral cortex, which appears to be related to urge incontinence and reduced bladder sensation. The studies also demonstrated that factors such as the reduced sensation of bladder filling, elevated fluid intake and infrequent voiding were common problems in elderly individuals.


Location of the pelvic floor muscles

Alzheimer’s Disease                      

We often only associate Alzheimer’s disease with severe memory loss, however, the disease can cause many physical difficulties and alter a person’s quality of life. One of these physical problems is incontinence. Individuals in the later stages of Alzheimer’s are particularly likely to experience this. Reasons for becoming incontinent can include failing to realise the need to visit the toilet, forgetting to go to the bathroom or being unable to find a toilet. Alzheimer’s disease can result in messages between the brain and the bladder or bowel not working as they should. This can even result in losing the control needed to empty the bladder or bowel. On some occasions, they may not understand a prompt from someone to use a toilet. New York University’s Dr. Barry Reisberg asserts, “as the disease evolves in this stage, patients subsequently become incontinent”. He explains, “urinary incontinence occurs first in people with Alzheimer’s then faecal incontinence occurs after”.



Damage to nerves that control the bladder     

Damage to the nerves controlling the bladder can be caused by diseases such as Multiple Sclerosis, Diabetes or Parkinson’s disease. These diseases are particularly common in seniors. When conditions such as Multiple Sclerosis cause a delay of the transmission of nerve signals controlling the bladder, an individual may experience incontinence. Diabetes, on the other hand, can cause damage to the peripheral, autonomic, and cranial nerves. Urologist Bradley W. Anderson, MD, asserts, “common symptoms of a diabetic bladder include a strong, frequent sensation of needing to urinate urgently. The underlying problem is that nerve damage causes the bladder to lose the ability to sense when it is full”. Dr Anderson explains that because the bladder doesn’t empty well, it fills up again quickly, causing frequent urination. He claims, “if a bladder is not emptying regularly, it can become so full that it overcomes the sphincter muscle and just overflows”. Similarly, while Parkinson’s is a disorder that progresses slowly, those suffering from the disease do experience physical limitations such as incontinence. As the disease attacks the brain, it affects the dopamine-producing cells. These cells are vital to brain health, as they deal with signals controlling muscle movement. As a result, this causes an inability to control the bladder muscles.



Prostate Problems

As men get older, they are more likely they are to have prostate problems. It is important to be aware that not all problems with the prostate indicate prostate cancer. In younger men, the prostate is about the size of a walnut and slowly grows larger as men get older. If the prostate becomes too large, it can cause urinary problems. A common problem in men is Benign Prostatic Hyperplasia. In this condition, the prostate is enlarged, but it is not cancerous. An enlarged prostate often presses against the urethra, making it difficult to urinate. If you are looking after an elderly father or relative who complains of having incontinence, it is important to take them to a Doctor to have them examined and checked. The Doctor will do a rectal check to check for BPH and other possible conditions.


Understanding Elderly Incontinence

A study in 2015 set out to capture the experiences of older people with incontinence and explore the link between incontinence and social isolation. Participants recorded a personal account of their experiences in a diary for three days. 20 people aged 65 or over with incontinence were asked questions about incontinence and how it impacts on their daily life. One participant explained how incontinence affected the ways she does simple tasks such as washing. She claimed, “lifting heavy stuff doesn’t help. I find if I lift anything I start leaking more and the one thing I’ve got to do here is to do my washing. It’s often heavy, so I do try to do my washing quite frequently so that I don’t have a lot”. The participants reported awareness of being viewed as socially incompetent in cultures where continence is a tacit precondition for being socially acceptable. In a similar study in 2003, 3 men over 60 years with post-prostatectomy urinary incontinence revealed that the stigma of incontinence heavily affects public and private identity.

Choosing a product for a senior depends on their mobility and level of incontinence. If they are more active, pull up pants are ideal. All in ones are more ideal for those who are bed bound and have severe incontinence.

Product Recommendations for Seniors

Attends Pull-Ons

Shop Attends Pull-Ons Range

  • For light to heavy urinary and faecal incontinence
  • Normal underwear feel
  • Maximum discretion
  • Built in pad


Shop TENA Slip

  • For heavier incontinence
  • Perfect for those with limited mobility
  • Built in pad
  • Discreet

Lille SupremPants

Shop Lille SupremPants

  • Cen be pulled up and down easily
  • Inner leg cuffs
  • For moderate to heavy incontinence
  • Unobtrusive and discreet

Attends Flex

Shop Attends Flex

  • Ideal for heavy urinary and faecal incontinence
  • Belted
  • Anatomically shaped core
  • Breathable textile back sheet

It is important therefore to take care of seniors with incontinence and help to erase the taboo and ignorance around the condition. If a senior relative or someone close to you has incontinence, you should remember that the condition is not voluntary. It is useful to identify the potential causes of their incontinence and try and find a solution. Read our blog for more information on senior citizens and incontinence.