​​​​​​​​Urinary incontinence (not being able to control your bladder) can happen to anyone. Getting older doesn’t cause urinary incontinence, but changes that happen as part of getting older can affect your bladder control.

There are some reasons why older people, particularly women, could have urinary incontinence:

• Chronic coughing and abdominal weight gain can put more pressure within the abdomen. These are common and usually the main reasons for urinary incontinence (especially stress incontinence) in older people.
• Estrogen levels get lower as you age and can affect how well your bladder works. Estrogen helps improve the health of the pelvic floor tissue. Estrogen levels can affect how well you can control your urethra and the urge to empty your bladder. Your urethra is the tube from your bladder to the outside of your body. The walls of your urethra can lose some of their ability to squeeze and control your flow of urine.
• Weak pelvic floor muscles can make it harder to hold or release your urine.
• Damage to the nerves that control your bladder from diseases like multiple sclerosis, diabetes, or Parkinson’s disease.
• Arthritis and other physical changes can affect how well you move and can make it harder for you to make it to the toilet on time.
• Your kidneys make more urine at night as you get older.
• Having a child. One out of 3 people who give birth could have urinary incontinence at some point because of damage to their pelvic floor muscles. Damage to your pelvic floor muscles can happen from having multiple pregnancies, large babies, long labour, or difficult delivery (including tearing or using forceps during delivery). 
• A prolapsed vagina or uterus, which is common when you're older, may cause the urethra to become blocked or descend, which afftects bladder control.
  
• ​Other health issues such as straining from chronic constipation, a pelvic bone fracture, surgery to remove perlvic organs, or medicines can all affect continence.
• Having too much caffeine can also cause problems that lead to urinary incontinence.

What you can do

You can help urinary incontinence issues by making changes in your diet, weight, lifestyle, and activities.

• Pelvic floor muscle exercises (Kegel exercises) can strengthen the muscles that support your bladder.
• Bladder training and timed voiding (peeing) can help you get better control of your bladder.
• Medicines may be prescribed to help with bladder control. But talk to your healthcare provider or pharmacist because some medicines for overactive bladder can cause cognitive decline in adults over age 65.
• Using vaginal estrogen or moisturizers may help. Talk to your healthcare provider.
  
• Medical devices like a vaginal pessary can help support your pelvic floor and lessen urine leakage.
• Avoid caffeinated drinks like coffee, tea, and pop because they can make you pee more. Don’t limit how much water you drink.
• Other lifestyle changes could include quitting smoking, removing triggers for asthma, treating constipation and weight management.  

If incontinence is affecting the quality of your life, see your healthcare provider for a full assessment, including a chest scan, lung function test, and to check if your abdomen is holding extra fluid (ascites).