Elderliness and Incontinence; or, The Fall of Woman

For elderly women, incontinence may come before the fall. A new study published in the Journal of Urology suggests that aging women who wet the bed are feebler and physically and mentally weaker than those who do not, and as a result have a higher risk of falling down. “The study data suggested that poorer overall physical functioning was associated with falls and that incontinence was a marker for poor physical functioning,” researcher at Sonoma State University Glenn Brassington, who wasn’t involved in the study, said. “The take-home message for me is that a multi-pronged approach including medical management, strengthening, health behaviors, and creating a safe environment will reduce falls and promote independent living and quality of life of older adults – women and men.”

Dr. Avita Pahwa and fellow researchers at the University of Pennsylvania monitored 37 women who were 74 years old on average and had urinary incontinence – half of which were at an increased risk for falls – to see which factors might render them more or less prone to falling in the middle of the night. Most of the women said they woke up at least one time during the night to go to the bathroom, while 68% reported waking up at least two times a night. Bedwetters had poorer physical performance test scores than women who didn’t wet the bed. Sixty-one percent of the women who wet their beds had a very high risk of falls. After adjusting for age, bed-wetting and physical function, the researchers found that only physical function linked to an increased fall risk. This may indicate that bed-wetting is a marker for fall risk in women who don’t seek care for urinary incontinence.

The study had several limitations, though. It was small, lacked data on sleep apnea and other conditions that can affect bedwetting, didn’t suggest any solutions – other than suggesting that the women may benefit from interventions intended to build upper body and lower limb strength, which might reduce the risk of falls – and quite frankly, the findings are not all that surprising. However, it does add to an enlarging body of evidence that supports efforts to decrease nighttime awakening and improve the ability of patients to safely navigate from bed to bathroom and back to bed, Brassington said told Reuters in an email.

Moreover, the study does address the one thing that has the most bearing on whether elderly women with incontinence have a higher risk of falls. “We think it has to do with getting up at night,” director of the women’s health clinical research center at the University of California, San Francisco Dr. Jeanette Brown, who also wasn’t involved in the study, said in a different email. “We think night lights may help and removing obstacles.” She added that women who get treatment for daytime urinary incontinence may reduce their risk of falls and fractures. And while we’re at it, why not other medical supplies for the elderly such as bed rails or grab bars? Both of which are available at Discount Medical Supplies (wink, wink).  

Related: Elderly at the bath: Medical Supplies for the elderly