Educational and behavioral modification programs for urinary incontinence among older women: A systematic review

Background: Often an unrecognized medical problem, urinary incontinence (UI), which affects many older women, can reduce overall quality of life (QoL). Few research focus solely on the comprehensive primary preventive methods of education/awareness and behavioral/lifestyle modification (monitoring, exercises, and lifestyle changes) of stress, urge, and mixed UI—the most common forms of UI among older women (middle-aged [45-64 years] and elderly [65+]).

Objective: The purposes of this review are to (1) analyze primary preventive approaches to UI among older women, (2) identify the efficacy of such evidenced-based interventions, and (3) highlight the needs in establishing recommendations for UI prevention to the U.S. Preventive Services Task Force.

Method: The search was conducted using keywords (e.g., urinary incontinence) on English-only articles from 1973 to January 2013 using PubMed and CINAHL databases. Articles were selected using inclusion criteria (e.g., primary preventive methods, types of UI, age, gender).

Result: The search yielded 7331 articles of which 20 were deemed relevant. Educational methods of informational packets and multimedia courses (n=3) increased knowledge and help-seeking behavior. Most of the behavioral/lifestyle methods (n=17) of monitoring, bladder training, exercises (pelvic floor muscle exercises), and lifestyle changes as weight loss reported some reduction of UI episodes and improved QoL.

Conclusion: UI is a major issue that many older women face, yet it is often left unaddressed, which only worsens the condition. Public health policies and research should be aimed at creating UI awareness and treatments should immediately address UI through primary preventive approaches before more invasive methods.