Report from NIA-sponsored conference asks: What don't we know about bladder control?

December 4, 2017, American Geriatrics Society

Nearly 40 percent of older women and up to 35 percent of older men live with distressing urinary symptoms, including difficulty with bladder control and urinating (sometimes known as "voiding"), which often compromise quality of life and overall health. The lack of truly effective and safe therapies for these challenges stems from insufficient knowledge of the biological mechanisms for urinary control, the impact of aging and disease on urinary control, and the relationships of symptoms to urinary health and overall well-being, so say researchers reporting on a prestigious conference hosted by the American Geriatrics Society (AGS) and funded by a grant from the National Institute of Aging (NIA) to George A. Kuchel, MD, FRCP, AGSF, Director of the UConn Center on Aging and Travelers Chair in Geriatrics and Gerontology at UConn Health.

A summary report published today in the Journal of the American Geriatrics Society emphasizes that the —the third in a series on common geriatric syndromes like , delirium, and sleep disturbances—holds promise for pin-pointing gaps in knowledge and building a better research agenda to improve care for us all as we age.

"Despite its prevalence among , incontinence remains under-reported and under-treated, a reality for many of the conditions addressed through the AGS-NIA conference series," said Phillip P. Smith, MD, Associate Professor of Surgery at UConn Health, an NIA-funded Beeson scholar, and a co-author of the report. "Bringing renowned leaders together to look critically at what we know, what we don't know, and how we can bridge that divide will not only lead to better treatments but also will help model the way to high-quality, person-centered care for all older adults."

That process begins by identifying gaps in clinicians' understanding of serious concerns like incontinence, according to the expert panel of conference attendees. Principal among these gaps, for example, are unanswered questions about social, health, and personal factors that contribute to urinary control failures such as overactive bladder, voiding symptoms, and urinary retention (the inability to completely or partially empty the bladder), impacting more than 30 million Americans.

Focusing on urinary incontinence, a leading cause of social isolation and distress for older adults, the panel also highlighted research questions not typically included in clinical data sets that drive new and better treatments. In this context, conference experts from many different disciplines reported on the current state of urinary incontinence research across four critical areas: basic science, translation of discoveries from the bench to the clinic, healthcare delivery, and the frequent yet under-recognized clinical overlap between incontinence and other common geriatric syndromes in the same individual—a critical focus of the AGS-NIA conference series.

"Risk factors common to all geriatric syndromes include older age, decline in functional independence, impaired mobility, and impaired cognition," notes the conference report. "Identifying common shared risk factors and pathophysiological mechanisms [will be key to] future research efforts."

Among other highlights, the conference report notes that behavioral therapy (forms of treatment that seek to identify and help change specific behaviors linked to health problems) has emerged as one of the most successful treatment options for addressing , though it still is not offered to most older adults. Lack of provider awareness for behavioral techniques may be one reason for the gap, along with reimbursement models that fail to account for the time it takes to teach behavioral therapy skills. Future goals for treating should include improving behavioral training to make it more effective, as well as offering that training more widely.

Explore further: Behavioral treatment can help control incontinence

More information: Journal of the American Geriatrics Society (2017). DOI: 10.1111/jgs.15157

Related Stories

Behavioral treatment can help control incontinence

September 1, 2017
Dear Mayo Clinic: For the past few years, I've noticed that, when I cough or sneeze, I sometimes leak a small amount of urine. Twice in the past month, I had this happen without warning. And, instead of it being a small leak, ...

Women's wellness: managing urinary incontinence

May 30, 2017
Urinary incontinence is a prevalent issue, with anywhere from 25 to 50 percent of women reporting an episode in the past year.

Dry mouth symptoms can be side effect of certain medications for older adults

October 27, 2017
For older adults, dry mouth can be a common side effect of prescribed medications. Having dry mouth means you don't have enough saliva, or spit, to keep your mouth wet. The condition can lead to problems chewing, eating, ...

Nonsurgical treatments suggested for women's urinary incontinence

September 16, 2014
(HealthDay)—Effective treatment options exist for women with urinary incontinence that don't involve medication or surgery, according to new guidelines from the American College of Physicians.

Over half of seniors plagued by incontinence, CDC says

June 25, 2014
(HealthDay)—More than 50 percent of older Americans struggle with incontinence, a new government report released Wednesday shows.

New genomic analysis promises benefit in female urinary incontinence

May 29, 2017
Urinary incontinence in women is common, with almost 50% of adult women experiencing leakage at least occasionally. Genetic or heritable factors are known to contribute to half of all cases, but until now studies had failed ...

Recommended for you

Toothpaste and hand wash may contribute to antibiotic resistance

June 19, 2018
A common ingredient in toothpaste and hand wash could be contributing to antibiotic resistance, according to University of Queensland research.

Combining different malaria vaccines could reduce cases by 91 percent

June 19, 2018
Using two experimental anti-malarial vaccines, which work in different ways, can greatly reduce the number of malaria infections in animal studies.

Blood signature could improve early tuberculosis diagnosis

June 19, 2018
A gene signature in the bloodstream could reveal whether someone is going to develop active tuberculosis (TB) disease months before symptoms begin. Such a signature has now been developed by a team led by the Francis Crick ...

Scientists uncover a factor important for Zika virus host species restriction

June 19, 2018
Princeton University researchers Qiang Ding, Alexander Ploss, and colleagues have identified one of the mechanisms by which Zika virus (ZIKV) circumvents immune control to replicate in human cells. The paper detailing this ...

Children's immune system could hold the key to preventing sepsis

June 19, 2018
Children's immune systems could hold the key to preventing life-threatening infections and sepsis, a new study has revealed.

Beware of getting a tattoo if your immune system isn't up to scratch, doctors warn

June 18, 2018
Getting a tattoo may have some unexpected complications if your immune system isn't up to scratch, warn doctors in the journal BMJ Case Reports.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.