Effects of Age on Urinary Function

Urinary incontinence (UI) is a symptom that has a significant impact on quality of life. In 2000, an estimated 17 million community-dwelling persons in the U.S. had UI, defined as daily episodes of urinary incontinence. An estimated 1.89 million residents of long-term care facilities were older than 60 years, and about 50% (945,000) of them had incontinence. The total cost of managing UI in the U.S. was $19.5 billion in 2000.1 Although men may have a lower prevalence of UI than do women, a significant percentage of aging males experience lower urinary tract symptoms (LUTS) and UI. The prevalence of incontinence in a community-based study was 24% among men and 49% among women. However, only 29% of men and 13% of women with incontinence sought care for their urinary symptoms.2 The prevalence of UI among men increases with age; it is reported to be 15.5%, 24%, and 30% in the age groups of 55–64, 65–74, and >75 years, respectively.3 The annual incidence of UI ranges from 8–12% among men over 65 years.4 The Canadian Urinary Bladder Survey found that incontinence was related both to age and gender. Overall, 5.4% of men and 28.8% of women had urge urinary incontinence, stress urinary incontinence (SUI), or mixed urinary incontinence.5 The increase in life expectancy is accompanied by a rising pandemic of chronic diseases, including UI. Approximately 20% of the labour force will be 65 years or older by 2020. The number of persons aged 85 years or older in U.S. will increase from 2 to 5% by the 2050. Physicians are soon likely to face an epidemic of older people with LUTS and UI.6