The Surprising Amount of Incontinence In Older Adults
The Surprising Amount of Incontinence In Older Adults
A 2014 report from the Centers for Disease Control entitled “Prevalence of Incontinence Among Older Americans,” detailed some surprising statistics. However, the report used a data set that made it impossible to supply any sort of averages because the data was sourced from:
- 2007–2010 National Health and Nutrition Examination Survey (NHANES) using in-home interviews with non-institutionalized participants
- 2010 National Survey of Residential Care Facilities (NSRCF) using reports provided by designated facility or agency staff members for 6,856 residential care facility and/or residents
- 2007 National Home and Hospice Care Survey (NHHCS) using data from 3,226 current home health care patients, and 3,918 hospice discharges
- 2009 Long Term Care Minimum Data Set (MDS) using data supplied by 2,416,705 nursing home residents
Response rates varied from 84% to 99%, and many medical groups took the reports apart and offered summary data to clarify the findings.
According to the team over at WebMD, the CDC report explained that more than half of all older Americans deal with some level of incontinence. Citing one statement from the research team, they explained that “half the population experienced urinary leakage or accidental bowel leakage, and about 25 percent had moderate, severe or very severe urinary leakage. And about 8 percent had moderate, severe or very severe bowel leakage.”
This far more than many might expect, especially because the impact of incontinence can be quite debilitating. After all, it has emotional, social, health and economic effects on those living with it. And because it does vary, it is helpful to take a few moments now to go over just what incontinence means if we are also to understand the many ways it affects older Americans managing it or living with it.
What is Incontinence?
A dictionary definition of incontinence says it is “inability of the body to control the evacuative functions of urination or defecation: partial or complete loss of bladder or bowel control”. It is caused by an astonishing list of issues, often more than a single issue, and when it is urinary incontinence, it can be described using five different types or categories:
- Stress – This is quite common and is NOT due to emotional stress but to physical strain such as coughing, lifting, or even pressure applied to the abdomen
- Urge – This is the type that many know as overactive bladder and which presents as a powerful urge to urinate only briefly before it is needed or even when the bladder is empty
- Mixed – This is a common issue and is a combination of the two types above
- Overflow – This is when the bladder cannot fully empty and results in bladder leakage as it refills
- Functional – This is incontinence that is a direct result of any issue that prevents adequate time or capability to reach the bathroom, e., a leg issue may cause incontinence because it is so difficult to get to the bathroom quickly
Urinary incontinence has many causes, but most relate to a weakening of the pelvic floor muscles that support the bladder and urethra. Additionally, overactive muscles may cause the condition, too.
Is it just a part of aging? No. In one summary report on the CDC investigation, “Dr. Tomas Griebling, a professor of urology at the University of Kansas and a spokesman for the American Urology Association, said incontinence increases with age,” but that it should not be viewed as inevitable or normal.
The CDC report said as much, pointing out that the percentages of adults with incontinence issues has maintained a flat line or remained the same. However, Dr. Griebling also explained that the aging of the current population signifies that there will be more with the condition in the future.
For example, those queried for the report who still lived in their homes demonstrated that over 50% had bladder and/or bowel incontinence (44% had bladder issues). Those in nursing facilities had similar rates.
Diagnosis is Important
Sadly, because many think that it is a simple part of aging, many do not get properly tested to determine the background cause, and if it relates to a medical condition or another issue. For example, at the first signs of bowel or bladder leaking, it is crucial to visit a physician.
This enables them to perform the proper physical exams, book the appropriate tests, ask questions about symptoms, and even do a review of medication regimens a patient might be using, and which could be a source of the problem. More in-depth testing may be required to examine how well a patient can empty the bladder, and whether there are any signs of cysts or infection. If a doctor suspects something other than pelvic floor muscle weakening, they may recommend a visit to a specialist known as a urologist.
Dealing with Incontinence
While there are medical interventions that can help, there are also many at-home remedies and incontinence products that can be used before any more extreme steps, such as surgery. For example, men and women alike can perform pelvic muscle exercises. These can be done by squeezing your pelvic floor muscles as if you were attempting to cut off a stream of urine or hold intestinal gas. Hold the muscles for a count of three, but as the National Institutes for Health warn, “Repeat, but don't overdo. Pull in the pelvic muscles and hold for a count of 3. Then relax for a count of 3. Work up to 10 to 15 repeats each time you exercise”. Do them three times a day and you will start to feel changes.
You can also use “timed voiding” that sets your consumption of fluids and urination on a very fixed routine. Combining pelvic floor training, timed voiding, and alternatives like biofeedback can often produce profound improvements for an older adult. Lifestyle changes like cutting out caffeine, eating more fiber, shedding extra weight and smoking cessation are also extremely helpful. Incontinence may be wildly prevalent, but it is not inevitable. See a doctor as soon as you notice signs of the issue and work with them to develop a plan to reduce the issues or even end them.