Beyond pads: promoting effective continence care in the community

Urinary incontinence is a common condition, especially prevalent among older adults, which has a profound impact on wellbeing and quality of life. The National Institute for Health and Care Excellence (NICE) (2025) defines urinary incontinence as any involuntary leakage of urine, and highlights that the main risk factor for this condition is older age, with prevalence increasing up to middle age, plateauing or decreasing between 50 and 70 years of age, and rising again with advanced age.

Urinary incontinence may occur as a result of abnormalities of the function of the lower urinary tract or of other illnesses that tend to cause leakage. However, for many, it is a consequence of the natural physiological changes that occur with ageing (NICE, 2025).

These age-related changes in the lower urinary tract include decreased bladder capacity and a feeling of fullness, decreased detrusor muscle contraction rate, decreased pelvic floor muscle strength and increased residual urine volume (Batmani et al, 2021). Damage to nerves that control the bladder from diseases such as multiple sclerosis, diabetes or Parkinson's, or conditions such as arthritis, which make it difficult to get to the bathroom in time, may also contribute to the development of urinary incontinence (National Institute on Aging, 2022).