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September 16, 1983

Palliation may block cure of incontinence in elderly

JAMA. 1983;250(11):1371. doi:10.1001/jama.1983.03340110005002

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While urinary incontinence in the geriatric population is a major problem, the "prevailing pessimism regarding incontinence treatment is... not justified," says Mark E. Williams, MD, assistant professor of medicine at the University of Rochester School of Medicine and Dentistry.

Williams elaborated on the subject recently at a Bethesda, Md, conference on "Evaluating the Elderly Patient: The Case for Assessment Technology."

British surveys have disclosed that incontinence affects from 2% to 26% of elderly persons in the community (only about half of whom are known to health care providers) and from 13% to 48% of those in hospitals. Prevalence is not associated with sex, increasing age (within the older age population), or urinary infection, but it has been related to gynecologic and urologic surgery, drug use, physical disability, and neurologic disease.

Incontinence results when bladder pressure is greater than sphincter resistance and, according to Williams, effective treatment depends on correctly classifying