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Urinary incontinence in seniors: Types, causes, and exercises for bladder control

Written by: Anna Davis

Reviewed by: Dr. Claire Hsing, DPT, Dr. Amy Renaud, PT, DPT, WCS

If you've ever had urine leakage when you laugh, sneeze, or cough, you're not alone. In fact, research says 60% of women and 35% of men over the age of 65 experience urinary incontinence.

Urinary incontinence becomes more common as we age. However, if it is bothersome or impacts the quality of your life, it’s important to know that effective treatment options are available. You are not alone and you don't have to manage it alone— speak with your healthcare provider to explore solutions tailored to your needs. Options may include lifestyle changes, medication, surgery and more.

Exercise is often a simple, effective way to prevent and manage urinary incontinence. Bold’s online classes make it easy to get started from the comfort of home.

What are the different types of urinary incontinence?

Urinary incontinence can present in different ways depending on the cause. Whether you are experiencing urinary leakage when you stand up from a chair, when you put your key in the front door, or after you walk away from the toilet, identifying the type of incontinence is the first step toward managing it. Common types include:

  • Stress incontinence: Urine leakage during times of effort or physical exertion, such as when you cough, sneeze, or lift something heavy. One cause of this is when our muscles don't work optimally which is common after childbirth. Other factors that can contribute to this type of leakage are aging, menopause, or pelvic surgeries such as prostate removal or a hysterectomy.

    • Initial treatment options include pressure management techniques, including pelvic floor exercises.

  • Urge incontinence: A sudden, strong need to urinate, even when your bladder isn’t full. This often occurs in older adults and can also be triggered by bladder irritation from infections, dehydration, or common bladder irritants such as coffee, tea, soda, or alcohol. Common symptoms are urine leakage when you hear running water, get close to the bathroom, or walk in your front door.

  • Mixed incontinence: A combination of the symptoms of stress and urge incontinence.

  • Functional incontinence happens when someone can't get to the bathroom in time. This may be due to physical challenges or cognitive problems, like dementia.

  • Overflow incontinence: Incomplete bladder emptying, often leading to dribbling or leakage. Often linked to urine blockage (e.g., enlarged prostate) or weak bladder muscles.

  • Other types: 

    • Bedwetting is known as nocturnal enuresis.
    • Postural incontinence is when leakage occurs as you change positions, like from sitting to standing.
    • Peeing during sex is known as coital incontinence.
    • Leakage after urination, called post-void dribbling, is common. It affects men with enlarged prostates and women with pelvic organ support issues.

When to talk to a doctor about bladder leakage

If you're experiencing urinary incontinence, it's important to talk to your healthcare provider about your treatment options. Seek medical advice if you notice any of the following: 

  • New onset or sudden increase in urinary leakage, urinary urgency, or urinary frequency.
  • Confusion or memory loss, associated with changes in incontinence.
  • Bedwetting or the inability to feel bladder fullness.
  • Sudden changes post-surgery (e.g., bladder problems after prostate surgery, bladder issues post-hysterectomy or after pelvic surgery).
  • Frequent UTIs (2+ in 6 months or less).

Your healthcare provider can help create a treatment plan. This plan may include different solutions, such as:

  • Bladder retraining programs
  • Pelvic floor physical therapy
  • Medications such as oxybutynin or mirabegron
  • Procedures like Botox or nerve stimulation

Not sure where to start? Check out Bold’s guide on how to talk to your doctor about pelvic health.

What leads to urinary incontinence as we get older?

Urinary incontinence can occur for a variety of reasons including muscle weakness, nerve damage, or underlying medical conditions. It has many risk factors, meaning there are various conditions and habits that can increase someone’s chance of experiencing urinary incontinence. If you’re interested in learning more about the causes of your condition, talk to your healthcare provider. 

Non-modifiable risk factors (things that can’t be changed):
  • Age-related decrease in muscle mass: As we age, we lose muscle, approximately 3–5% every 10 years. This includes the muscles that support your bladder and control urination. Weak muscles can make it harder to hold in urine, causing urinary incontinence.
  • Hormone changes after menopause: After menopause, women have lower levels of estrogen. This can cause muscle tissue to thin and lose support. This increases the risk of pelvic floor disorders, like urinary incontinence and pelvic organ prolapse. 
  • Reduced bladder capacity: With age, the bladder holds less and signals urgency sooner. This means you may feel the need to go more often, even if there isn’t much urine.
  • Cognitive decline: Diseases such as Alzheimer’s and Parkinson’s impact how the brain connects with the bladder. This can make it harder to know when to go or to get to the bathroom in time.
  • Prostate issues: After prostate surgery or if the prostate is enlarged, overflow and stress incontinence can occur.
Modifiable risk factors (things that can be changed):
  • Foods and drinks that irritate the bladder: Certain foods and fluids can increase symptoms of urinary urgency and leakage. Coffee, tea (even herbal), alcohol, and fizzy drinks like soda or sparkling water can make symptoms worse. Acidic foods and drinks, such as lemon water and tomato juice, may also play a role.
  • UTIs: Urinary tract infections can increase the urge to urinate, which can sometimes lead to involuntary leakage.
  • Weight gain and obesity: Weight gain can put more stress on the bladder, which can contribute to urinary incontinence. 
  • Lack of physical activity: A sedentary lifestyle can weaken pelvic floor muscles. This makes it harder to control bladder movements.

Lifestyle changes to support bladder health

If you're dealing with urinary incontinence, you can adjust certain factors to help manage it. Try practicing these healthy habits: 

  • Avoid bladder irritants such as caffeine, alcohol, and spicy and acidic foods which can worsen urgency and bladder sensitivity.

  • Bladder retraining: This method uses a set schedule for bathroom breaks, known as a voiding schedule. Over time, you extend the intervals between urinations.

  • Healthy hydration: Staying well hydrated is important for a healthy bladder. Many people with urinary incontinence limit their intake of liquids in hopes that this will decrease the leakage. But smaller amounts of urine can become more concentrated, contributing to more urgency and leakage. It can also encourage more bacteria, which may lead to infections. Dehydration can also lead to other health problems.

  • Medication checks: Certain types of blood pressure medications can lead to an increased urge to urinate. If you have incontinence, talk to your doctor. They can help rule out medications as a contributor to your symptoms, and potentially work with you to find alternative solutions if appropriate.

  • At-home modifications: Make sure your home is free of clutter and has clear paths for walking. Remove any tripping hazards, such as loose rugs or electrical cords that may hinder your access to the bathroom. 

  • Discreet bladder protection: Stay comfortable and confident with absorbent products that manage incontinence. Use discreet products like adult diapers, incontinence pads, or bed pads as needed, but don’t rely on them alone.

Exercises to prevent bladder leakage

We need to keep our pelvic muscles strong and flexible, like other muscles. This helps us respond when we need to use the bathroom. If you experience urinary incontinence, your healthcare provider may recommend some key movements and routines:

  1. Kegel exercises, also known as pelvic floor contractions, involve tightening and relaxing the muscles that support the bladder. These are the same muscles you use to hold back urine, stool, and gas. When functioning properly, these muscles contract to prevent urine leakage and relax to allow normal elimination. Practicing Kegels regularly can help improve strength, coordination, and control—supporting better bladder function over time.

  2. Diaphragmatic breathing: Try slow breathing to calm bladder spasms. This also builds awareness for better bladder control.

  3. Combination moves: Combine strength training and pelvic engagement. This helps you coordinate new skills including motor control and strength in the pelvic floor during more complex movements like walking, lifting, or navigating stairs.

    • Explore combination moves like Kegel squats in Bold classes.

  4. Strength training: Strengthen the muscles around the pelvic area, like the core, hips, and legs. This can help with stability and bladder control.

  5. Walking supports circulation, core strength, and posture. These factors all help with urinary control.

  6. Urge control techniques: These can be helpful when you experience a strong urge to urinate. Steps include:

    • First: Stop activity, stand quietly, or sit down. Put some pressure on the pelvic area using your hands or leaning forward while sitting. Try to stay very still to maintain control. Avoid rushing to the toilet.
    • Second: Contract your pelvic floor muscles by squeezing and letting go 5-10 times to keep from leaking or maintain a holding contraction if you feel as though leakage will occur if you relax the muscles. Pelvic floor contractions send a message to the bladder to relax and hold urine. You can also try raising your heels off the floor 10 times while sitting or standing. Try to distract yourself by thinking of something other than going to the bathroom.
    • Third: Relax. Do not rush to the toilet. Take a deep belly or diaphragmatic breaths and let it out slowly. Let the urge to urinate pass by using distraction techniques and positive thoughts.
    • Last: If the urge returns, repeat the above steps to regain control. When you feel the urge decrease, walk calmly to the bathroom.

Explore hundreds of online exercise classes including Bold’s pelvic floor exercise program today. Take any time from the comfort of your home. Not yet a Bold member? Check if you’re eligible for Bold at no cost through your health plan or provider. See you in class!

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