William Gibson1, Theodore Johnson2, Ruth Kirschner-Hermanns3, George Kuchel4, Alayne Markland5, Susie Orme6, Joan Ostaszkiewicz7, George Szonyi8, Jean Wyman9, Adrian Wagg1. 1. Division of Geriatric Medicine, University of Alberta, Edmonton, Alberta, Canada. 2. Department of Medicine, Division of Geriatric Medicine and Gerontology, Emory University School of Medicine, Atlanta, Georgia, USA. 3. Klinik der Urologie und Kinderurologie, Universitätsklinikum Bonn, Bonn, Germany. 4. UConn Center on Aging, University of Connecticut, Farmington, Connecticut, USA. 5. Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham, Birmingham, Alabama, USA. 6. Care of the Elderly Department, Barnsley Hospital NHS Foundation Trust, Barnsley, UK. 7. Director of Aged Care, National Ageing Research Institute, Melbourne, Victoria, Australia. 8. Department of Geriatric Medicine, Balmain Hospital, Sydney, New South Wales, Australia. 9. School of Nursing, University of Minnesota, Minneapolis, Minnesota, USA.
Abstract
BACKGROUND: Evidence-based guidelines for the management of frail older persons with urinary incontinence are rare. Those produced by the International Consultation on Incontinence represent an authoritative set of recommendations spanning all aspects of management. AIMS: To summarize the available evidence relating to the management of urinary incontinence in frail older people published since the 5th International Consultation on Incontinence. MATERIALS AND METHODS: A series of systematic reviews and evidence updates were performed by members of the working group to update the 2012 recommendations. RESULTS: Along with the revision of the treatment algorithm and accompanying text, there have been significant advances in several areas of the management of lower urinary tract symptoms in frail older people. DISCUSSION: The committee continues to note the relative paucity of data concerning frail older persons and draw attention to knowledge gaps and research opportunities. Clinicians treating older people with lower urinary tract symptoms should use the available evidence from studies of older people combined with careful extrapolation of those data from younger subjects. Due consideration to an individual's frailty and wishes is crucial.
BACKGROUND: Evidence-based guidelines for the management of frail older persons with urinary incontinence are rare. Those produced by the International Consultation on Incontinence represent an authoritative set of recommendations spanning all aspects of management. AIMS: To summarize the available evidence relating to the management of urinary incontinence in frail older people published since the 5th International Consultation on Incontinence. MATERIALS AND METHODS: A series of systematic reviews and evidence updates were performed by members of the working group to update the 2012 recommendations. RESULTS: Along with the revision of the treatment algorithm and accompanying text, there have been significant advances in several areas of the management of lower urinary tract symptoms in frail older people. DISCUSSION: The committee continues to note the relative paucity of data concerning frail older persons and draw attention to knowledge gaps and research opportunities. Clinicians treating older people with lower urinary tract symptoms should use the available evidence from studies of older people combined with careful extrapolation of those data from younger subjects. Due consideration to an individual's frailty and wishes is crucial.