State of the science: Conservative interventions for urinary incontinence in frail community-dwelling older adults

This systematic literature review aimed to identify conservative interventions for reducing urinary incontinence (UI) in non-institutionalized frail older adults. Randomized and quasi-experimental studies published in English reporting outcomes on UI frequency, severity, or quality of life were included and rated for quality. Studies reporting improvements over 50% in UI outcomes were considered clinically significant. Seven studies with 683 participants (75% female) were eligible. Multicomponent behavioral interventions including pelvic floor muscle exercises and bladder training had the strongest evidence for reducing UI. The evidence supporting comprehensive geriatric assessment with multicomponent behavioral interventions, pattern urge response training, and toilet skills was limited. There is insufficient evidence to derive firm conclusions regarding the use of conservative interventions. Clinical trials are needed on a variety of interventions to guide practice on UI prevention and management in frail community-dwelling older adults.