1. Definition and Cost

Urinary incontinence (UI) is defined as the involuntary loss of urine. While UI is often described by patients as the predominant bothersome symptom of the lower urinary tract, the overall term of voiding dysfunction (VD) constitutes a broader definition of urinary pathology referring to any anomaly in normal storage of urine as well the spontaneous and controlled elimination of urine. Advancing age is a primary risk factor for UI, with multiple studies linking UI to the risk of institutionalization. A variety of psychological issues are associated with UI in older adults including depression, feelings of isolation, embarrassment, and anxiety.^1,2

In addition to the personal costs, both financial and social, there are significant healthcare costs involved with managing UI in the elderly. In the United States, it has been suggested that the economic impact of UI may exceed $26 billion annually.³ Overall, UI and VD can and should be actively treated even in elderly and often frail older patients. Evaluation and management of urinary issues in the elderly needs to be specifically tailored to the individual patient’s issues and functional status.

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