Why is Incontinence in Elderly Females so Common?

A recent cohort study found that incontinence affects more than a fifth of people aged over 85 years old.

 

Urinary incontinence is much more common in older people and is associated with considerable morbidity. 20% of community dwelling older adults have enough incontinence to limit some aspect of their lives. It is associated with considerable morbidity. The risk of incontinence, however, is much higher in older females. It is that is thought that up to 50% of older women suffer from urinary incontinence.

Dr Fleming, president at ACP asserts, “Urinary incontinence is a common problem for women that is often under-reported and under-diagnosed”.

Are You a Senior Woman with Incontinence? Post on our Forum for Tips and Advice

Why is Incontinence in Elderly Females so Common?

Risk Factors for Seniors

Seniors are more at risk of nerve damage, mobility issues and arthiritis. Problems with nerve damage affect the communication between the brain and the bladder. Parkinson’s disease is a common problem that causes individuals to lack control over their bladder. Mobility issues can cause functional incontinence, making it hard to reach the toilet and buy the correct products. In addition to this, seniors are also more likely to develop cognitive problems such as Dementia.

 

Changes to the Female Bladder

Elderly women differ from younger females by the presence of several changes in the urinary tract. As you get older, the bladder also changes. A woman's elastic bladder tissue toughens and becomes less stretchy with age. A less stretchy bladder doesn’t hold as much urine as before, causing you to urinate more frequently. The bladder wall and pelvic floor muscles also weaken with age, making it harder to empty the bladder fully.

Older women are also more likely to get UTIs as the bladder muscles weaken and make it hard to empty the bladder fully.

Health Factors Exclusive to Women

There are a number of key factors exclusive to women that play a factor in causing incontinence. Common contributing factors are the following:

  • Menopause. Oestrogen plays a vital role in continence mechanism with the bladder and urethral function becoming less efficient with age. During menopause, the body suddenly stops producing oestrogen. This can cause lack of bladder control.
  • Pregnancy. The weight of pregnancy puts extra pressure on the bladder, weakening the muscles. Childbirth further damages these muscles through the stretching and strain of the muscles during birth.
  • Hysterectomy. A hysterectomy is an operation to remove a woman’s uterus. This can also remove some structures that are required to provide pelvic support for bladder control.

 

The combination of these factors can alter the condition of the bladder and pelvic floor. This makes incontinence much likely later in life.

Find out how reduced oestrogen can cause female incontinence.

Although not exclusive to women, obesity is another key risk factor for incontinence in elderly females. In fact, this factor is a common cause of leaks along with a hysterectomy.

Interesting Fact:

Incontinence in Older Women is more Common than most Chronic Medical Conditions!

Older People and Seeking Treatment

Older people are more likely to delay seeking help for urinary incontinence. Symptoms are often also poorly managed in care. Drug treatments and conservative treatments have been proven to work in older people. However, older people still remain under treated. Embarrassment may be a key cause for this. Linda Brubaker, MS, professor of female pelvic medicine and Loyal University Chicago School of Medicine, states, “female incontinence is embarrassing. It can really affect your quality of life-your emotional state, body image, sexuality”. One main reason as to why senior women don’t seek help is due to normalizing the condition. We all know that incontinence is more prevalent in older people, so women often feel like they should just accept it. Brubaker asserts, "many women think it’s normal, part of having children or going into menopause and don’t seek help."

Is your incontinence caused by nerve damage? Read more about Neurogenic Bladder 

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This Thursday 11th April marks Parkinson’s Awareness Day. Parkinson’s is a neurological condition, which like many others, can cause neurogenic Bladder.

 

What is Neurogenic Bladder?

Neurogenic bladder is bladder dysfunction caused by neurologic damage. This damage can be due to internal or external trauma, disease or injury. Diseases commonly associated with Neurogenic Bladder include:

 

  • Parkinson’s Disease. Parkinson’s Disease occurs due to loss of nerve cells in part of the brain called the Substantia Nigra. Due to this, a reduction in a chemical called dopamine occurs. This chemical has a key role in regulating body movement.
  • Multiple Sclerosis. MS is actually one of the most common causes of disability in younger adults. It is an autoimmune disorder that affects the brain and spinal cord, causing symptoms such as problems with vision, arm or leg movement, sensation and balance.
  • Diabetes. Diabetes causes your blood glucose levels to be too high. High blood sugar can cause an increase in the amount of urine produced. If blood sugar levels are not under control, this can cause nerve damage.

  • Cerebral Palsy. Cerebral palsy is a permanent movement disorder that causes poor coordination, stiff muscles, weak muscles and tremors. It can also cause problems with vision, sensation, speaking, swallowing and hearing.
  • Spina Bifida. Spina bifida is a fault in the spinal cord development in which there is a gap or split in the spine.
  • Sacral Agenesis. Sacral agenesis is a congenital disorder in which there is abnormal fetal development of the lower spine.
  • Dementia causes long-term and gradual decrease in the ability to think and remember. It causes a greater decline in mental functioning than expected in usual aging.

Neurogenic bladder is also commonly caused by infection of the brain or spinal cord, heavy metal poisoning, Stroke, spinal cord injury or pelvic surgery.

Are you looking after someone with Dementia and Incontinence? Read how you can Provide Exceptional Care 

Why do Neurological Disorders Impact Bladder Control?

Most of us don’t give much thought to how our nervous system affects the urinary system. However, our nervous system actually plays a big part in regulating the storage of urine in the bladder and bladder coordination. Our nerves and muscles work together for your bladder to hold urine until you are ready to empty it. Nerve messages go back and forth between the brain and the muscles controlling bladder emptying. Damage to the nervous system can cause problems that affect the lower urinary tract, which includes the bladder, the urethra and the sphincters. This damage therefore means these muscles lose the ability to hold or release urine at the right time.

 

Depending on the damage done to your nerves, you can actually either have underactive or overactive bladder. Overactive bladder symptoms include urinating frequently in small amounts and experiencing loss of bladder control. It can also mean having a strong urge to urinate and having problems emptying the bladder fully. An underactive bladder, on the other hand, can cause an inability to feel when the bladder is full and the bladder filling above normal capacity. People often also experience urinary retention, which is the inability to empty the bladder.

What can be Done to Treat Neurogenic Bladder?

Catheterisation is often provided for people with a Neurogenic Bladder. These are thin tubes that are inserted through the urethra into the bladder to drain urine.

In some cases, surgery is the best option. Bladder augmentation is a common surgery method, where intestines are removed and attached to the bladder wall. This increases the bladder’s ability to store urine. Another method is injecting Botox into the bladder or urinary sphincters.

Doctors may also recommend various lifestyle changes, such as avoiding bladder irritants. It is recommended that you cut out coffee, spicy foods and citrus fruits. Your Doctor may recommend a healthy diet plan for you Being overweight can also worsen incontinence, so it is advised that you maintain a healthy weight.

If you need more tips on managing a neurogenic bladder, you can read our living with incontinence section

What Can You Do for Parkinson’s Awareness Day?

Parkinson’s Awareness Day was created to increase understanding of Parkinson’s as a serious condition. Many people with Parkinson’s do not feel understood or feel like they aren’t taken seriously. You can host your own World Parkinson’s Day Event and approach your local media with a story, or even place Parkinson’s UK’s artwork at your local bus stop. You can visit Parkinson’s UK for artwork and campaign material to download.

Recommended Heavy Incontinence Products

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Buy Lights by TENA

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Surgery is a common method of treating prostate cancer that hasn't spread outside the prostate gland. Radical Prostatectomy is the most common type, and involves the surgeon removing the entire prostate gland.

 

Types of Radical Prostatectomy

The type of radical prostatectomy performed can vary and depends on the hospital. Keyhole surgery, minimally invasive surgery, involves making five or six cuts to remove the prostate. Robot-assisted surgery means the surgeon uses three robotic arms controlled from a computer. During open surgery, a single cut is made in the stomach.

Unfortunately, incontinence is a common side effect of Prostate Surgery. However, incontinence experienced by men is often only light and temporary. But exactly how long do you have incontinence after Prostate Surgery?

 

Incontinence after Prostate Surgery: What to Expect

You can rest assured that the incontinence you experience after prostate surgery isn’t likely to involve complete bladder emptying. Rather, the short-term incontinence experienced by most is more of a slight drip or leak. This happens most often during strenuous activity or when pressure is placed on the bladder.

There is no standard amount of time that is expected of incontinence. However, patients who experienced normal continence prior to surgery should regain function within 12-13 months of their surgery. There is never an 100% guarantee of this rule, however surgeons work their hardest to cut this time down. Luckily, with the advanced techniques available today, the majority of people should only expect short term side effects.

man with prostate cancer with doctor

Are you managing incontinence after Prostate Surgery?

Post a question on our forum to receive expert advice

forum incontinence

It’s rare that men experience long term incontinence after prostate cancer treatment. As a general rule, if your incontinence symptoms last over a year, you should contact a Doctor. There are a number of procedures that exist to restore continence if you do find yourself with long term incontinence.

 

Why Does Incontinence Occur after Prostate Surgery?

The prostate gland actually sits at the base of the bladder. The urethra runs through the center of the prostate gland. Where the bladder and urethra join, there is a ring of muscles called the bladder neck sphincter. These muscles are vital for our bladder control in staying continent. The bladder neck sphincter closes to prevent urine leaking out, but opens to allow urine to pass. Temporary incontinence occurs due to distress to the bladder neck sphincter during the surgery.

Have you had a Robotic Prostatectomy? Read all about Managing Incontinence Post Surgery

Choosing an Incontinence Product

Choosing an incontinence product depends on the severity of your incontinence and your mobility. If you only have the occasional light leak, a low absorbency “light” product is ideal. Typically, small incontinence pads are the most ideal for light incontinence. For more moderate leaks, a larger pad or pant product is recommended. For heavy to severe incontinence, an all in one pad is ideal. However, it is very rare that people have heavy incontinence after Prostate Surgery.

If you have low mobility or are immobile, a pad is your better option. Pants are harder to put on and take off than simple pads, as they require a full product change.

Recommended Incontinence Pads for Men

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Buy Attends for Men

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£6.19 to £16.29

Buy TENA Men

  • Available in 3 absorbencies
  • Maximum security and discretion
  • Confio Air
  • For light to heavy incontinence

 £5.44

Buy iD for Men

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  • Enhanced comfort and security

£2.19 to £4.84

Read our Guide to the Top 10 Incontinence Pads for Men for Product Inspiration

Recommended Incontinence Pants for Men

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From £7.35

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  • Close body fit
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  • For light to moderate urinary and faecal incontinence
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From £10.49

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  • Cotton-like fabric
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Looking for Men’s Incontinence Pants? Read our Guide to Choosing the Best Male Incontinence Pants

Incontinence is a huge issue for many people with debilitating brain conditions. The relationship between Vascular Dementia and Bowel Incontinence is a common problem that is barely spoken of.

This week is brain awareness week. This is a global campaign to increase public awareness of the progress and benefits of brain research. Lectures, panel discussions and lessons are held each year to educate people on the function of the brain. The relationship between the brain and the bowel is discussed frequently. It can be incredibly hard to take care of someone with Vascular Dementia and Bowel Incontinence. Understanding the link can be a key step to accepting and learning about their condition.

What is the Relationship Between the Brain and Bowel Function?

It is the muscles within the rectum and anus that help to control your bowels. The sphincter muscles are responsible for the release of stool. The relationship between the brain and bowel is more important than you may think. Just like how our bladder becomes full and sends signals to the brain to let it know, our digestive system becomes full and sends signals about its fullness to the brain. The brain then sends signals via the nerves to keep the external sphincter closed. These signals begin in the brain and go to the spinal cord and continue to the nerves located in the sacral area of the back. They then go down to the rectum and external sphincter muscles. The brain's signals are important to ensure the muscles only release stool when it is appropriate.

bowel incontinence sphincter muscle

Are you caring for someone with Vascular Dementia and Incontinence? Post on our Forum and Receive Expert Advice.

incontinence forum

What is Vascular Dementia?

Vascular Dementia is caused by reduced blood flow to brain. This often results from a serious of tiny strokes, also known as “infarcts”. These strokes damage and destroy some brain cells. The condition can also be caused by a single stroke, in which the blood supply to part of the brain is suddenly cut off. In addition to this, it can also occur to the narrowing of small blood vessels in the brain. This is also called “Subcortical Vascular Dementia”.

Vascular Dementia affects an estimated 150,000 people in the UK. The condition does gradually get worse over time, although on some occasions it can be slowed down. Vascular Dementia can impair an individual's memory, language and motor skills.

woman worried incontinence

Exploring the Link Between Vascular Dementia and Incontinence

Vascular Dementia thinking changes can range from mild to severe. It is generally only the most severe cases of Vascular Dementia that can cause bowel incontinence. The damage and death of brain cells that control the bowel interrupts the communication between the brain and bowel. Some people with Vascular Dementia therefore develop bowel incontinence.

Faecal incontinence also occurs due to other cognitive complications. These include the following:

  • Feeling disorientated and confused
  • Difficulty with motor skills and balance
  • Slowness of thought
  • Memory and language problems. This can make communication difficult. If someone is relying on another person for care, language problems can mean they do not communicate when the bowel is full

Taking Care of Someone with Vascular Dementia and Bowel Incontinence

Find the Right Product for Them

Maintaining their dignity means providing them with a product that meets their needs. Read our Guide to Choosing Bowel Incontinence Products for guidance on choosing a product.

Recommended Bowel Incontinence Products

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Buy Attends Flex

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Patience is Key

Being gentle and patient is key when helping someone with bowel incontinence. This is true for both communicating with them and changing products. If you are unsure about changing products, read our guide to Putting on Incontinence Pads and Pants for an Individual.

 

 

Talk with a Doctor

Talk to a Doctor about options that apply to the person you’re caring for. You should also ask about any appropriate medication. Some medications can be helpful for calming the bladder and bowel. Some of these do have side effects that can worsen Dementia, so it is important to get expert advice.

 

Ensure they Have a Healthy Lifestyle

Experts recommend the following tips:

  • Avoid caffeine
  • Do gentle exercise regularly
  • Eat plenty of fiber
  • Limit liquids at night-time
  • Avoid bladder irritant foods such as spicy foods

 

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Incontinence is a word most people say quietly. For most people, it is discussed only with a Doctor, or never at all.

However, the studies that have taken place over the years never fail to shock people. The majority of studies have found that incontinence affects around 300m people worldwide. This equates to about 5% of the population. A huge issue is that due to the lack of talk about it, there may be many more people suffering from incontinence than has been found. To date, it is estimated that around 7 million people in the UK have urinary incontinence (5-10% of the population). The fact that many do not even see a Doctor means this proportion could be even higher. 

The infographic below shows the partition on a population of 50 million people:

incontinence infographic

Image provided by Ontex Healthcare, (September 2018)

Yes, it affects more women. But don’t forget about the men.

As you may expect, incontinence does affect more females than males. Incontinence affects roughly twice as many women as men. Combined faecal incontinence and urinary incontinence affects 10% of women and 5-6% of men in the community, increasing to almost 50% in nursing home residents.

This increase in prevalence is due to common changes in a woman’s health and body, such as pregnancy, hormonal changes, menopause and ageing. In pregnancy, the expanding uterus puts pressure on the bladder. The muscles in the bladder sphincter and the pelvic floor muscles can be overwhelmed by this and become weakened. Increased uterine weight is another huge important factor affecting the frequency of leakages during pregnancy. During childbirth, these muscles are further stretched and weakened, leaving many women suffering from stress incontinence.

 

Are You Experiencing Leakage During Pregnancy? Read our Guide to Pregnancy and Incontinence

Over 10% of men over 65 admit to having urinary incontinence to some degree. Most commonly, male bladder problems are caused by Prostate Cancer, Prostate Surgery, neurological disorders and nerve damage. Many men suffer from benign prostatic hyperplasia, a non-cancerous condition that causes prostate enlargement. Constipation, obesity and bladder infections are other complications that can lead to male incontinence symptoms.

Are You a Man with Incontinence

Post a Question on Our Forum

“I’d Rather Keep It a Secret”

Although we have rough statistics, the fact is that it is hard to estimate how many people have incontinence, as it is barely spoken of. Fewer than half of adults with severe urinary incontinence seek help from healthcare providers. One study found that men would rather admit to sexual impotence than symptoms of incontinence. Women are a little bit more open about the issue, sharing these problems on websites such as “Mumsnet” and “Women’s Health”. However, still only 1 in 5 women claim that they seek help for incontinence issues, the rest keep it a secret. We clearly still do need to spread incontinence awareness for both sexes.

What is the Most Common Type of Incontinence?

Stress incontinence is the most common incontinence type, often brought on by pregnancy, menopause and other problems.

 

Symptoms of stress incontinence are the following:

  • Experiencing leakage when you exercise
  • Experiencing leakage when you cough, laugh or sneeze
  • Leaking when standing up
  • Leaking when lifting something heavy.

Author and runner Rose George shared her experience of stress incontinence an article in the Guardian. She states, “I know it happens from discussing it with my female club mates. I know it happens from running forums online. And I know it happens because it happens to me.”

 

Surprising Fact: More people suffer with bladder problems than with asthma, diabetes or epilepsy!

The Risk Factors For Incontinence Include:

In general, individuals of child bearing age are more likely to have slight incontinence, whereas senior individuals are much more likely to have severe incontinence. The increase in prevalence around the age of 50 is likely to be due to Menopause.

Recommended Heavy Incontinence Products

Buy iD Expert Belt on Incontinence Supermarket

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  • Designed for heavier incontinence

Range from £7.98 to £11.05

Buy Attends Pull Ons on Incontinence Supermarket

  • Feel like normal underwear
  • Close comfortable fit

Range from £10.11 to £21.19

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  • Fixation tabs
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  • For heavier incontinence

Range from £10.69 to £19.94

Recommended Light Incontinence Products

Buy iD Expert Light on Allanda

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Range from £1.60 to £2.25

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Range from £3.10 to £6.12

 

Buy Lille Suprem Light on Allanda

  • Small in size for discretion
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Range from £0.99 to £4.35

 

The Impact of Incontinence on the Population

 

Studies find that incontinence influences four important areas:

1. Sexuality

2. Existing partnerships

3. New partnerships

4. The search for professional help

Incontinence is a threat to people’s autonomy and incontinence. This toll on mental health is not only apparent for incontinence sufferers, but also for carers. As authors Cassells and Watt claim in their article, "Carers of people with incontinence have reported sleep deprivation, depression and social isolation". They state “It is a both a caregiver burden and predictor of institutional placement.”

Depression and incontinence is also a large issue on a worldwide scale. In a Canadian study of women with urinary incontinence, more than 15 percent had experienced major depression in the previous year.

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