Screening for Urinary Incontinence in Geriatric Patients

Initial Screening Approach

The American Geriatrics Society recommends that all geriatric patients should be routinely screened for urinary incontinence during annual evaluations, as this condition is commonly unreported by patients and undetected by providers, yet significantly impacts quality of life 1
Direct questioning about urinary incontinence symptoms during routine geriatric assessment is recommended, as patients rarely volunteer this information 1, 2
Annual screening is recommended, particularly for patients with diabetes mellitus who are at higher risk for urinary incontinence 1, 2

The European Urology association suggests asking specifically about the following urinary symptoms: frequency, urgency, and incontinence episodes 3, 4
Assess for risk factors that predispose to urinary incontinence in geriatric patients, including diabetes mellitus (particularly in women) 1, 2
The American Geriatrics Society recommends assessing for other risk factors, such as polyuria or glycosuria 1, neurogenic bladder and autonomic insufficiency 1, medication use, especially those with sedating effects 2, restricted mobility 1, and cognitive impairment 2

A focused physical examination should be conducted to identify urinary tract infection (UTI) 1, 3, urine retention 1, fecal impaction 1, and atrophic vaginitis or vaginal candidiasis in women 1

Failing to screen for urinary incontinence due to time constraints or discomfort with the topic can have significant consequences, including overlooking the impact of urinary incontinence on quality of life, according to the American Geriatrics Society 1, 2
Overlooking the significant impact of urinary incontinence on quality of life, including social isolation, depression, falls, and fractures, is a common pitfall 1, 2
The Annals of Emergency Medicine warns against placing indwelling catheters for management of incontinence without proper indications, which increases risk of infection 5