Incontinence may seem like an embarrassing condition to have. It’s losing control of your body, and something you don’t really want to talk about with others. However, if you suffer from urinary incontinence or fecal incontinence, you’re not alone. A 2014 study found that over half of all seniors struggle with some level of incontinence.
If you’re developing incontinence, there’s likely some underlying cause, a condition leading to the leakage. Your doctor knows your health best! So, if you truly want to find out the cause, it’s best you speak with a medical professional. But what are the most common causes of incontinence in older adults?
What Is Incontinence and Why Does It Happen?
Incontinence is the inability to control one’s urination or defecation. As we stated above, it’s very common, though often not discussed due to embarrassment. In a 2013 study, Urinary Incontinence in the Older Adult, authors Kristen Cook and Linda Sobeski broke incontinence down into four common groups.
- Stress urinary incontinence: Leakage caused by an increase in intraabdominal pressure through actions like coughing, laughing, or exercise.
- Urge urinary incontinence: Leakage occurs due to an inability to delay voiding (or, not being able to hold it anymore) after the body perceives the bladder as full.
- Overflow incontinence: When force is applied to an overfilled bladder, causing stress incontinence, or other effects of retention affect the bladder, causing urge incontinence. (Basically, the bladder is too full, so small amounts of urine leak out like putting water into a bottle that’s already full.)
- Functional incontinence: Inability to void waste due to impairment of cognitive, psychological, or physical ability or environmental factors.
These groups can be useful as they begin to break down different forms of the functional cause of incontinence. That said, there are mixed types of incontinence, complicating diagnoses. Additionally, within each group, there are more specific causes that will need to be addressed to either stop the leakage or deal with the incontinence so that it doesn’t become a hinderance to one’s daily life.
If you’re experiencing leakage issues, you’ll want to see a doctor to figure out the cause. Temporary (or transient) incontinence will likely clear up as soon as you remove or overcome the trigger. Long-term or chronic incontinence, on the other hand, will usually need some sort of treatment that your doctor can help you with and could be a sign of a more serious condition. When talking about the most common causes of incontinence in a patient of any age, you’ll likely be talking about DIAPPERS. (No, not diapers.)
DIAPPERS is a mnemonic device created by health care workers to remember the most common causes of incontinence. Those are:
- Delirium: Delirious patients, with a brain disorder, may not even be aware their bladders are full
- Infection: Specifically, a urinary infection like a UTI (urinary tract infection)
- Atrophic conditions: These irritate or weaken tissues involved in the elimination process
- Pharmaceuticals: Some drugs may cause incontinence as a side effect
- Psychological disorders: There are a number of tangential psychological factors that can lead to incontinence
- Excessive urine output: More urine means more stress on your system, raising the chances of leaks
- Restricted mobility: If you struggle to make it to the bathroom, leaks may become more common
- Stool impaction: There are a few ways that constipation can cause incontinence
Many seniors may experience incontinence caused by issues that are a bit more specific to them, even if they fall under one of these categories.
One issue directly related to incontinence is age. As we get older, a number of the DIAPPERS causes can become more likely. More specifically related to age is that our muscles can often get weaker. Bladder tissues can become less elastic with age, leading to the bladder holding less urine. This requires more frequent emptying and a greater risk of incontinence simply due to the frequency that one must relieve themselves. It can also lead to leaking, since the muscles used to hold urine in may not be strong enough to do so anymore.
Incontinence in Senior Women
In women, especially those going through menopause, there are two conditions that come with aging that can lead to incontinence: atrophic vaginitis and atrophic urethritis. Atrophic vaginitis (or vaginal atrophy) is the thinning, drying, or inflammation of the vaginal walls due to the body producing lower levels of estrogen. Atrophic urethritis is similar, but for the walls of the urethra. It’s also caused by the body producing less estrogen during menopause. Both conditions lead to an increased chance of urinary tract infections and a lowered ability to combat stress incontinence.
Incontinence in Senior Men
Among men, incontinence can often be a sign of an issue with the prostate. An enlarged prostate can put pressure on the urethra, resulting in a weakened urinary stream, followed by frequent urination and leakage. As the enlarged prostate progresses, it can become a benign prostatic hyperplasia, a common condition where the enlargement is chronic and may worsen over time. If you’re a man and experiencing these symptoms, you should see a doctor immediately, since the other prostate condition that shares these symptoms is prostate cancer. Both conditions can cause incontinence in men and are more common the older you get.
● ● ●
Having “accidents” can be embarrassing and distressing, especially if they’re happening regularly. But you’re not alone. Many seniors have faced or will face similar issues during their lifetime, so it’s nothing to be ashamed of. Talk with your doctor about your incontinence and begin to find out why you’re having these episodes. It’s the first step to living with or resolving your incontinence!