An overactive bladder isn’t just a nuisance and a source of embarrassment. For the elderly, it can also trigger a potentially fatal fall, a Canadian study says. An overactive bladder is the inability to control the release of urine from your bladder. Studies show that Blacks experience incontinence than whites, but at a higher severity.
“Falls are the leading cause of accidental death in seniors, and many people don’t know that having bladder control problems makes you about twice as likely to fall over,” study lead author William Gibson, an assistant professor of geriatric medicine at the University of Alberta says.
“There’s not previously been a lot of evidence that treating people’s incontinence reduces their risk of falling. So this is a jumping-off point, because now we’ve demonstrated that the sensation of urgency is a source of distraction,” Gibson adds.
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What the study shows
The study included nearly 30 older adults with overactive bladder. Their gait was monitored as they walked the length of the lab and back three different times: under normal conditions; while doing a simple mental test meant to distract them; and after drinking enough fluids to make them have the urge to pee.
The need to urinate caused gait changes similar to those seen when doing the distracting mental task: The gait tended to become slower and narrower, which is associated with an increased risk of falling, the researchers say.
“This is pretty good evidence that people with incontinence are being distracted by their bladders, which means that they’re less able to concentrate on walking,” Gibson shares.
“Being balanced and walking require some cognitive inputs, and for young, healthy people, they don’t have to think about walking,” he explains. “But when you’re older, with changes to the brain, it requires more cognitive input to maintain balance. If you’ve then got a distracting factor of your bladder, it makes you more likely to fall.”
Incontinence is a common issue in older adults, but it’s not talked about much, even between doctors and patients, Gibson says.
How to help your loved one
“If you’re a family physician looking after someone who is having problems with falls, one of the things that should be asked is, ‘Are you also having problems with your bladder?’ If so, then what can be done about that?” he notes.
Some options include using the bathroom at a set time, pelvic floor exercises, avoiding caffeine, tea, sodas, alcohol, juices, or a lot of fluids before bed and certain activities, keeping your weight down, stopping smoking and double void (using the bathroom, waiting a few minutes and going again to avoid a quick trip to the bathroom).
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How to prevent falls
Taking care of your overall health is the biggest key to preventing falls.
Try these tips from the NIH to prevent yourself from falling:
- Stay physically active. Regular exercise improves your muscles and makes you stronger. It can also help keep your joints, tendons, and ligaments flexible. Try mild weight-bearing activities, such as walking or climbing stairs to slow the bone loss that usually happens with osteoporosis.
- Have your eyes and hearing tested. Even small changes in sight and hearing can cause you to fall. After getting new glasses or contact lenses, take the time to get used to them. Always wear your glasses or contacts when you need them. If you wear a hearing aid, be sure it fits well and wear it.
- Find out about the side effects of any medicine you take. If you notice that a drug is making you sleepy or dizzy, you should tell your doctor or pharmacist immediately.
- Get enough sleep. If you are sleepy, you are more likely to fall.
- Try limiting the amount of alcohol you drink because even the smallest amount of alcohol can affect your balance and reflexes. Studies show that the rate of hip fractures in older adults increases with alcohol use.
- Stand up slowly. Getting up too quickly can cause your blood pressure to drop and make you feel wobbly. It is important that you regularly check your blood pressure. Try checking it when you are lying and standing.
- Use an assistive device if you need help feeling steady when you walk. Although you may feel like you don’t need it, the appropriate use of canes and walkers can prevent falls. If your doctor tells you to use a cane or walker, make sure it is the right size for you and the wheels roll smoothly. This is important when you’re walking in areas you may not know well or where the walkways are uneven. You can also enlist the help of a physical or occupational therapist who can help you decide which devices might be helpful and teach you how to use them safely.
- Be very careful when walking on wet or icy surfaces. In order to make them less slippery, try to have sand or salt spread on icy areas by your front or back door.
- Wear non-skid, rubber-soled, low-heeled shoes, or lace-up shoes with non-skid soles that fully support your feet. It is important that the soles on your shoes are not too thin or too thick. Avoid walking on stairs or floors in socks or in shoes and slippers with smooth soles.
- Always tell your doctor if you have fallen since your last checkup, even if you aren’t hurt when you fall. By telling your doctor, you can alert him or her to a new medical problem or problems with your medications or eyesight that can be corrected. Your doctor may suggest physical therapy, a walking aid, or other steps to help prevent future falls.
Having a fear of falling becomes more common as we age.
However, don’t allow it to stop you from doing the activities you love. With the tips listed above, you can remain active while also lowering your risk of falling.
For added protection, try doing things like getting together with friends, gardening, walking, or going to the local senior center.