While at NAFC, we have long echoed the mantra that loss of bladder or bowel control is not an automatic consequence of aging, there are some certainties we can anticipate as we age. These include the formation of cataracts, the wearing out of joints, inflammation, and arthritis, the cumulative effects of exposure to the sun such as wrinkling and even skin cancer, graying of hair, the loss of muscle and tone, and for most of us a widening waistline and increased inactivity. We have to work at combating the inevitable effects of aging with protective steps such as wearing sunglasses and moisturizing sunblock, exercising regularly and wisely, and more carefully watching our consumption of calories and nutrients. Since chronic disease and degenerative illness have replaced infectious diseases as the leading cause of death in the U.S., we are confronted with the compounded impact of multiple health conditions and disorders as we enjoy extended longevity into our 80's and beyond.
Take nocturia, for example, or getting up more than once a night to urinate. Here is a case of where age-related changes can and do affect the bladder. Changes in bladder function as we age typically increase frequency and urgency, largely due to reduced bladder elasticity and contractibility. With the bladder not fully emptying when we urinate, the brain receives more frequent signals it needs emptying. This is known as overactive bladder, or OAB. (Such symptoms may also signal a neurological disease, such as MS.) The incidence of OAB increases sharply in women after menopause as urethral and vaginal tissues become drier in the presence of less estrogen. Nonetheless, by age 80 both genders are equally affected.
Nocturia increasingly occurs as we grow older, in large part due to OAB symptoms, beginning in the 40's for many people. It is also believed that since growth hormones are no longer being released as we older adults sleep, urine production nocturnally increases. While complicated by sleep disorders which also increase as we grow older, the biggest challenge with nocturia is safe toileting until symptoms are fully managed. That's because of all of the other health disorders and problems confronting us: impaired mobility, loss of balance, impaired eyesight, etc. Falls are the fifth leading cause of death in older people. Often leading to hospitalization and even nursing home placement due to fractures, the direct cost of fall injuries in people 65 and older exceeds $19 billion, according to the CDC.
Preempting bladder and bowel control symptoms before they become big problems - to reduce the risk of falls in the night - starts with getting educated. Visit us online to learn more about nocturia. Think about how your daytime habits are affecting your nighttime habits. Understand your anatomy and learn the vocabulary to explain the changes in your body to your doctor as they appear. Become aware of the benefits of combination therapy, such as medications for OAB undertaken with bladder retraining and pelvic floor muscle (PFM) exercises. Embark on a lifelong commitment to a PFM.
Smoking cessation, exercise routines that include stretching and strength-building, and maintaining a healthy weight all help with bladder control as they do with other chronic diseases such as chronic obstructive pulmonary disease (COPD,), multiple sclerosis, and Type II diabetes, respectively. Bowel health is enhanced by avoiding chronic constipation, with daily consumption of dietary fiber, proper hydration, and physical activity.
Of course, we can't age backwards, like F. Scott Fitzgerald's Benjamin Button. But going forward, we can live life both offensively and defensively with fewer accidents and greater quality.
NAFC Executive Director
Published On: May 28, 2009