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What Are the Best Medications to Treat Urinary Incontinence In the Elderly?

Person taking medications out of a bottle

Edited by Marlee Septak, Copywriter at Aeroflow Urology.

Along with the many other physical changes that occur with age, many of us will most likely experience a loss of bladder control as we grow older.

Referred to as urinary incontinence, this condition affects a countless number of elderly individuals nationwide. It presents unique challenges and discomforts for caregivers and seniors alike, but it doesn’t have to affect quality of life.

Medical science has made strides in developing medications to address the symptoms of urinary incontinence, and in this article, we’ll tell you which drugs will work best to help your loved one manage and lessen symptoms.

What Causes Urinary Incontinence In the Elderly?

The main contributing factors of urinary incontinence (UI) for Ciswomen include:

  • Hormonal changes in the urogenital tissues secondary to menopause.
  • Nerve injury.
  • Weak pelvic floor muscles.

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For Cismen, contributing factors include:

  • Enlarged prostate.
  • Constipation
  • Detrusor muscle dysfunction.
  • Urinary tract infection (UTI).

Common Types of Incontinence In the Elderly

Urge incontinence, sometimes called overactive bladder (OAB), is the most common type of UI in seniors. It is secondary to overactive detrusor muscle activity and limited mobility in reaching the restroom once the urge has been encountered. The main symptom is the sudden and intense urge to urinate, leading to leakage.

Another type of UI is stress incontinence. With stress incontinence, an individual will leak urine due to weakened pelvic floor muscles, common with aging. The main symptom of stress incontinence is leaking urine when coughing, sneezing, exercising, bending over, or lifting heavy objects.

When Should Medication Be Used for Urinary Incontinence In the Elderly?

Many older adults avoid social activities because of their UI symptoms. Medications can help get your loved one back out to the activities they enjoy, creating a more supportive mental health environment. When lifestyle changes (see below) are still not improving urinary symptoms by at least 50%, or if your loved one’s quality of life is diminished, consider using medications as a treatment for UI.

What Are the Best Medication for Urinary Incontinence In the Elderly?

It’s important to remember that each person will react differently to each drug, so speak with your loved one’s healthcare provider before trying new treatments.

Anticholinergics

Anticholinergic drugs block the signals that trigger bladder contractions (associated with urge incontinence or OAB). Types of anticholinergics that may work for UI include:

  • Oxybutynin
  • Solifenacin
  • Fesoterodine
  • Darifenacin
  • Tolterodine
  • Trospium

Side Effects

  • Dry mouth.
  • Dizziness
  • Constipation
  • Nausea
  • Vomiting
  • Headache
  • Blurred vision
  • Reflux
  • Confusion
  • Urinary retention / hesitancy.
  • More severe concerns include glaucoma, psychosis, seizures, tachycardia, and angioedema.

Risk Factors

Caution should be advised for those with dementia, Parkinson’s disease, constipation, ulcerative colitis, glaucoma, alcohol use, and GERD.

Beta-adrenergics

Beta-adrenergics work by promoting relaxation of the detrusor muscle (bladder muscle). These types of medications may be more tolerated in elderly patients. It is also recommended that seniors taking beta-adrenergics monitor their blood pressure due to increased blood pressure. Types of beta-adrenergics include:

  • Mirabegron
  • Vibegron

Side Effects

  • Stuffy nose.
  • Headache
  • Tachycardia
  • Nausea
  • Elevated blood pressure.
  • More severe concerns include uncontrolled hypertension, urinary retention, and angioedema.

Risk Factors

Uncontrolled hypertension and renal impairment are contraindications.

Note: All urge incontinence / OAB medications are not recommended if someone has a bladder outlet obstruction or urinary retention.

If your loved one is taking medication for UI, follow-ups with a healthcare provider or urologist are crucial to catching side effects early and making adjustments as needed. Starting at a low dose and building up from there is key to tolerability.

Connect with your loved one’s provider 4-6 weeks after they begin taking a medication and every 3-4 months after that until a stable dose has been achieved with optimal symptom improvement. Minimize the side effects of medicines by starting UI treatment alongside lifestyle changes.

What Is the Newest Drug for Urinary Incontinence?

Gemtesa is the newest medication on the market and has been known to have a lower side effect profile, especially for older adults. 

Lifestyle Changes for Urinary Incontinence In the Elderly

1. Use free incontinence products for seniors, such as adult diapers, adult pull-ons, or bladder control pads to protect against leakage.

2. Avoid constipation.

3. Increase water intake (despite being contrary to what you might believe) throughout the day.

4. Limit foods and beverages that cause bladder irritation (citrus, spicy, caffeine, etc).

5. Don’t smoke tobacco.

6. Practice timed voiding or bladder training.

7. Decrease fluids 2 hours before bedtime.

8. Try pelvic floor physical therapy or pelvic floor muscle exercises (Kegel exercises).

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1. Submit your information through our form to verify your coverage.

2. Call your doctor for a prescription for incontinence products.

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Aleece Fosnight

Aleece Fosnight, MSPAS, PA-C, CSC-S, CSE, NCMP, IF, HAES is a Medical Advisor and Writer for Aeroflow Urology and a board-certified physician assistant specializing in sexual medicine, women’s health, and urology. In 2019, she opened up her own private practice, the Fosnight Center for Sexual Health, and implemented the sexual health grand rounds curriculum at her local hospital and residency program.

Aleece is also the founder of the Fosnight Foundation, a non-profit organization dedicated to the education and training of professionals in the sexual health field and providing funding for access to healthcare services in her local community.

Disclaimer

Information provided on the Aeroflow Urology website is not intended as a substitute to medical advice or care from a healthcare professional. Aeroflow recommends consulting your healthcare provider if you are experiencing medical issues relating to incontinence.

urinary incontinence Incontinence in Elderly

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