Dementia and bladder control: Common problems, causes, and treatment options Health ConditionsHealth ConditionsAlzheimer's & DementiaAnxietyArthritisAsthma & AllergiesBreast CancerCancerCardiovascular HealthCOVID-19Dermatology & SkincareDiabetesEnvironment & SustainabilityExercise & FitnessEye HealthHeadache & MigraineHealth EquityHIV & AIDSHuman BiologyInflammatory Bowel DiseaseLeukemiaLGBTQIA+Men's HealthMental HealthMultiple Sclerosis (MS)NutritionParkinson's DiseasePsoriasisSexual HealthWomen's HealthDiscoverNewsLatest NewsOriginal SeriesMedical MythsHonest NutritionThrough My EyesNew Normal HealthPodcastsHow to understand chronic painWhat is behind vaccine hesitancy?The amazing story of hepatitis C, from discovery to cureNew directions in dementia researchCan psychedelics rewire a depressed, anxious brain?Why climate change matters for human healthToolsGeneral HealthDrugs A-ZHealth HubsHealth ToolsBMI Calculators and ChartsBlood Pressure Chart: Ranges and GuideBreast Cancer: Self-Examination GuideSleep CalculatorHealth ProductsAffordable Therapy OptionsBlood Pressure MonitorsDiabetic SuppliesFitness TrackersHome GymsGreen Cleaning ProductsHow to Shop for CBDQuizzesRA Myths vs FactsType 2 Diabetes: Managing Blood SugarAnkylosing Spondylitis Pain: Fact or FictionConnectAbout Medical News TodayWho We AreOur Editorial ProcessContent IntegrityConscious LanguageNewslettersSign UpFollow UsMedical News TodayHealth ConditionsDiscoverToolsConnectSubscribe What to know about dementia and bladder controlMedically reviewed by Shilpa Amin, M.D., CAQ, FAAFP — By Ana Luiza Dias on September 30, 2022People with dementia often experience difficulties using the bathroom. Accidents and incontinence due to dementia can be upsetting and cause problems as the condition progresses. Dementia is an impaired ability to remember, think, or make decisions. The condition can interfere with a person’s everyday activities. People with dementia may have trouble using the bathroom for various reasons, including changes in behavior, language and communication difficulties, and an inability to recognize the need to go. In many cases, it can be hard to identify one sole cause. Read on to learn about the relationship between dementia and bladder control, the main issues relating to this condition, their causes, and treatment options. Does dementia affect bladder control Share on PinterestSasirin Pamai/EyeEm/Getty ImagesDementia describes a group of conditions that involve the loss of cognitive function. It affects memory, thinking, orientation, comprehension, calculation, learning, language, and judgment. It may also cause mood and behavior changes. About 53% of people with dementia have incontinence. This is significantly more than is typical. Urinary incontinence or loss of bladder control is the unintentional passing of urine, which can be distressing for individuals with dementia and their caregivers. Why it happens People living with dementia may experience urinary incontinence or bathroom issues for many reasons, including:memory issues and a reduced ability to concentrate on daily tasks, making them forget they need to use the bathrooman inability to recognize the physical sensation of needing to go to the bathroomchanges in behavior, such as resisting going to the toiletlanguage or communication problems that prevent the person from getting help when necessary These causes are complex and involve a variety of psychological and functional factors. Therefore, it can be hard to identify a specific cause. The main physical reason is that for people with dementia, signals that allow communication between the bladder and the brain control the ability to pass urine. As the bladder fills, the central nervous system (CNS) sends signals to a brain region called the pontine micturition center (PMC). This signal reaches the bladder to promote urination. The CNS also plays a role in bladder contraction and the voluntary release of urine. This requires coordinating the relaxation of the muscles receiving input from the autonomic nervous system, which handles involuntary body functions, and those that the PMC controls. Lesions in the brain regions that control urination can also affect bladder control and lead to urinary incontinence. These lesions can result from protein deposits such as amyloid plaques and neurofibrillary tangles, which are common in people with Alzheimer’s disease, the most common type of dementia. Consequences A lack of bladder control has various adverse effects on an individual. It can cause:feelings of embarrassment or loss of dignitylow self-esteemdepressionskin problems due to prolonged exposure to urine or fecesincreased risk of urinary tract infections (UTIs) Managing bladder and bowels The first step in managing incontinence in people with dementia is thoroughly assessing the problem. After that, an individual, their caregiver, and medical professionals can implement coping strategies. Assessment In this assessment, the healthcare professional will perform a physical evaluation and ask a few questions to understand:a person’s medical historyspecific times of the day where incontinence occursthe presence of urinary or fecal incontinencethe volume of urine or feces a person passesthe effect of incontinence on quality of life The doctor may also ask the individual or their caregiver to record information regarding their fluid intake and the occurrence of incontinence. A physical examination includes a urine dip test, bladder scan, or in-and-out urine catheterization. The urine dip test can show signals of UTIs, kidney inflammation, dehydration, and diabetes. These conditions can contribute to urinary incontinence. The bladder scan, or in-and-out urine catheterization, can show if there is any incomplete bladder emptying and urinary retention. How to reduce and manage accidents Doctors should involve spouses, relatives, and carers in planning management strategies. As much as possible, healthcare professionals should also involve the individual. Management strategies for people with dementia and incontinence include:Promoting a toileting pattern: For example, taking an individual to the toilet after breakfast or when they are most likely to have incontinence.Reminders: These involve frequently asking the person if they need to use the toilet.Medications: This can help ease some symptoms such as urge and stress incontinence.Incontinence pads: These can help keep the person dry and reduce any complications relating to incontinence. However, they will not prevent it from happening — they are there for severe cases when other strategies do not work. Incontinence pads come in various formats, including disposable inserts, wrap-around pants, pullup pads, and reusable models.Managing fluid intake: A person should avoid excessive fluid consumption, especially before bed. Caregivers can encourage them to drink enough water throughout the day to avoid dehydration.Caffeine: People should avoid excess caffeine since it can stimulate urination and irritate the bladder. Treatment options Treatment may involve medication, pelvic and bladder muscle strengthening exercises, and lifestyle modifications. In severe cases, a person may need surgery.Bladder training: These are exercises that requirefollowing a fixed bathroom schedule whether or not the person feels the urge to urinate. If they feel the urge to urinate before a specific interval, they can use relaxation techniques to suppress it. After achieving success, the person should extend the interval by several minutes.Pelvic floor exercises: There are exercises to strengthen the muscles around the bladder, bottom, vagina, or penis.Medication: The doctor may prescribe anticholinergic agents to decrease urine leakage. The currently available medications include oxybutynin, tolterodine, solifenacin, and trospium. However, they can cause side effects, most commonly dry mouth and constipation. In males with an enlarged prostate, a doctor may prescribe medications that relax the prostate and improve incontinence, such as alpha-blockers.Catheterization: Doctors only recommend this in severe cases or when wounds take time to heal. The procedure involves using a thin, flexible tube to carry urine out of the bladder. When to contact a doctor Trouble using the bathroom or loss and loss of bladder control are common symptoms in people with dementia. Individuals with urinary incontinence symptoms, such as leakage of urine when sneezing, laughing while lifting light weights, or a sudden urge to urinate, should seek medical help. Summary Dementia has a range of effects, and losing bladder control can affect a person’s quality of life. However, there are strategies to manage incontinence and avoid accidents. These include nonpharmacological measures, such as exercises to strengthen bladder muscles and behavioral adjustments. Medications can also help reduce urine leakage and prevent the negative consequences of incontinence. Last medically reviewed on September 30, 2022Overactive Bladder (OAB)Alzheimer's / Dementia 4 sourcescollapsedMedical News Today has strict sourcing guidelines and draws only from peer-reviewed studies, academic research institutions, and medical journals and associations. We avoid using tertiary references. We link primary sources — including studies, scientific references, and statistics — within each article and also list them in the resources section at the bottom of our articles. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.Bartolone S. N., et al. (2021). Urinary incontinence and Alzheimer's disease: Insights from patients and preclinical models. https://www.frontiersin.org/articles/10.3389/fnagi.2021.777819/fullMurphy, C., et al. (2021). Problems faced by people living at home with dementia and incontinence: causes, consequences and potential solutions. https://academic.oup.com/ageing/article/50/3/944/6035277?login=truePayne, D. (2020). Managing incontinence in people with dementia [Abstract]. https://pubmed.ncbi.nlm.nih.gov/32881611/What is dementia? (2019).https://www.cdc.gov/aging/dementia/index.htmlFEEDBACK:Medically reviewed by Shilpa Amin, M.D., CAQ, FAAFP — By Ana Luiza Dias on September 30, 2022 Latest newsWhat sets 'SuperAgers' apart? Their unusually large neuronsOmega-3 may provide a brain boost for people in midlifeSeasonal affective disorder (SAD): How to beat it this fall and winterCDC: Monkeypox in the US 'unlikely to be eliminated in the near future'Why are more women prone to Alzheimer's? New clues arise Related CoverageWhat is dementia? Symptoms, stages, types, and moreMedically reviewed by Shilpa Amin, M.D., CAQ, FAAFP Dementia refers to symptoms that affect memory, communication, and thinking. It features in Alzheimer's disease. Learn about symptoms, stages, and…READ MOREWhat are the early signs of dementia?Medically reviewed by Nancy Hammond, MD There are 10 early signs and symptoms of dementia, including misplacing things, difficulty solving problems, and confusing times and places. Learn…READ MOREMedical myths: All about dementia As part of our Medical Myths series, this article covers 11 myths about dementia, including the role of vitamins and supplements and ways to reduce…READ MOREScientists find previously unknown link between metabolism, brain healthREAD MOREWeekly nightmares during middle age may be linked to higher dementia riskREAD MORE