Incontinence, the sleeping geriatric giant: challenges and solutions

Key points• The prevalence of urinary incontinence increases in association with increasing age.• Behavioural and lifestyle interventions, including exercise, are effective in older people.• There is an increasing evidence base for pharmacological therapy of urgency incontinence in the elderly and frail elderly.• Surgical management for older men and women is associated with benefit but should be performed with due regard to potential benefits and harms, remaining life expectancy, and the expectations of both patient and, where relevant, caregiver.• Continence care should be based around provision by specialist nurse practitioners working within a multiprofessional, integrated service.