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Overactive bladder in the vulnerable elderly

Authors Wolff G, Kuchel G, Smith P

Received 5 June 2014

Accepted for publication 26 June 2014

Published 3 October 2014 Volume 2014:6 Pages 131—138


Checked for plagiarism Yes

Review by Single-blind

Peer reviewer comments 2

Gillian F Wolff,1 George A Kuchel,2 Phillip P Smith1,2

1Division of Urology, Department of Surgery, 2UConn Center on Aging, University of Connecticut Health Center, Farmington, CT, USA

Abstract: Overactive bladder (OAB) is a common problem that may occur in individuals of all ages. It has a considerable impact on patient quality of life, and although moderately effective management strategies do exist, this condition often remains undiagnosed and untreated. OAB needs to be viewed as a symptom complex. Its presentation and management are complicated in the vulnerable elderly by the presence of baseline frailty and multiple coexisting chronic conditions. Furthermore, and beyond a simple understanding of symptomatology, providers must address patient goals and motivations as well as the expectations of caretakers. These multiple levels of perception, function, expectations, and treatment efficacy/risks must be tailored to the individual patient. While the vulnerable elderly patient may often have evidence of urinary tract dysfunction, OAB and urge urinary incontinence in this population must be understood as a multifactorial geriatric syndrome and viewed in the context of medical and functional baseline and precipitating risk factors. Expectations and goals must be tailored to the resources of vulnerable elderly patients and their caregivers, and care must be coordinated with other medical care providers. The management of OAB in the vulnerable elderly often poses significant management challenges. Nonetheless, with a thoughtful approach and an aim towards future research specifically for this population, significant reductions in morbidity and mortality long with enhancement in health-related quality of life are possible.

Keywords: urinary incontinence, urgency, antispasmodics, aging, frailty

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