[Urinary incontinence].

Urinary incontinence is a common health problem of older adults and affects more than 50% of nursing home residents. Different types of urinary incontinence can be distinguished: urgency, stress, overflow (urinary retention) and extra-urethral incontinence. The pathogenesis of urinary incontinence in older patients is multifactorial. Age-related physiologic changes, urological or gynaecological ailments, neurological diseases, behavioural patterns and functional decline frequently contribute to incontinence to some extent. These pathogenetic factors may appear in close relation to frailty. As incontinence on the one hand may substantially contribute to decompensation of health reserves, and on the other hand is an indicator for frailty, early assessment and treatment are important. Clinical diagnostics focus on history, physical examination, bladder diary and measurement of postvoid residual volume. Diagnostic and therapeutic approaches to urinary incontinence should focus on finding and treating reversible causes. Behavioural interventions such as toileting procedures may reduce the level of incontinence even in severe cases. Frail older adults with functional decline and urgency incontinence often do not respond well to drug treatment. Paramount for the adequate care for incontinent seniors is the instruction of the affected person and--if necessary--of their caregiver in handling incontinence aids.