Treat urge to prevent injury.

Incontinence puts older women at risk for falls

BLADDER CONTROL PROBLEMS THAT send older women rushing to the bathroom at night may also increase their risk of falls and fractures, researchers report.

Urinary incontinence, falls, and fractures are all common health problems in elderly women. Now, investigators have evidence that weekly or more frequent incontinence independently boosts an older woman's risk of falls and bone breaks. In a study of more than 6,000 women aged 72 and older, those with frequent urinary incontinence were about 25 percent more likely than women without the condition to suffer a fall. They had a one-third greater risk of fractures not involving the spine.

Researchers led by jeanette S. Brown, MD, of the University of California, San Francisco, report their findings in the July issue of the Journal of the American Geriatrics Society (Vol. 48, No. 7)]. Only women with what is called urge incontinence carried a higher risk of falls and fractures. People with this condition feel an overwhelming need to empty their bladders, but often cannot make it to the bathroom. Weakened pelvic muscles, bladder dysfunction, and certain medications may underlie the problem.

In the current study, more than half of the women fell at least once over an average of three years. Urge incontinence, according to Brown's team, accounted for some of that risk. "Our findings suggest that identification and treatment of urge incontinence may be an effective intervention for reducing the risk of falls and fractures."

Although falls have been considered an unfortunate consequence of urinary incontinence, until now there has been no strong evidence that the condition actually increases the risk, of such accidents, according to an editorial published with the report.

Steve L. Wolf, MD, and his colleagues at Emory University School of Medicine in Atlanta, write that this study offers a "compelling argument for urge incontinence as an additional risk (factor) for fall-related occurrences." He adds, "Vigorous study should be devoted to combining drug therapies for incontinence with injury-prevention strategies like strength and balance training."