Age-related differences in self-management and reporting of incontinence

In this video, Aleece Fosnight, MSPAS, PA-C, CSC-S, CSE, IF, MSCP, HAES, highlighted the distinct generational differences in how patients experience and discuss urinary incontinence. Among younger adults, particularly those under 40, embarrassment and stigma remain significant barriers to seeking care. Many in this age group delay treatment, often relying on anonymous resources such as online searches, websites, or even artificial intelligence tools to learn more privately. Despite their broader access to information and increased awareness of pelvic health and preventive strategies, younger patients often perceive their symptoms as either too mild or too abnormal to discuss openly, creating a gap between awareness and action.

In contrast, older adults—especially those over 65—commonly experience mixed incontinence, such as stress and urge incontinence, but tend to normalize their symptoms. Many attribute bladder control changes to aging, believing “this is just how it is.” Rather than immediately seeking medical help, they frequently adopt self-management strategies. These include limiting fluid intake, restricting social activities, or timing outings around bathroom access. Such adaptive behaviors can mask the severity of symptoms for years, delaying appropriate intervention until the condition becomes more advanced.

Fosnight emphasized that many older patients eventually pursue care only after years of coping, when their quality of life has been significantly affected. A lack of awareness about treatment options, limited local resources, and the fact that providers often do not proactively ask about incontinence further contribute to delays in diagnosis and treatment.

Ultimately, Fosnight underscored the importance of breaking down stigma, encouraging earlier conversations, and ensuring providers initiate discussions about bladder health. By bridging generational barriers and addressing both the silence of younger patients and the normalization of symptoms in older adults, clinicians can help patients access treatment sooner and improve long-term outcomes.