A recent survey on the use of drugs for incontinence in the elderly stated that only anticholinergic drugs used for urge incontinence have a slight positive effect on incontinence episodes. However, this does not mean that there are no potential treatments for incontinence in the frail elderly. The Dutch surveillance on problems in the care sector, the ‘National prevalence survey of care problems’ (‘Landelijke prevalentiemeting zorgproblemen’), shows that between 2004 and 2014 the prevalence of urinary incontinence dropped from 76% to 49%. This fall in prevalence is due to the policies developed by institutions, and by training for nurses and physicians. Successful treatment begins with assessment of functionality (mobility and cognition), assessment of relevant multimorbidity and reconsideration of the use of drugs with an impact on continence. As a next step, bladder retraining and pelvic floor exercises may be used if the elderly person is able to perform these exercises independently. An anticholinergic drug can be tried as a last resort if there is urge incontinence and there are no contraindications.
Conflict of interest and financial support: an ICMJE form provided by the author is available online along with the full text of this article.