Older adults tend to which of the following regarding bladder control?

• A. Increase control
• B. No change
• C. Have a stable continence
• D. Lose voluntary control of bladder

Answer: (D)

As people age, the urinary system undergoes changes that commonly reduce bladder control. The bladder becomes less roomy and its lining may lose elasticity, while the detrusor muscle can become less coordinated or more prone to overactivity. Weakening pelvic floor muscles, especially in women, reduces support for the bladder and urethra, making it harder to hold urine. The urethral sphincter can lose tone, and factors like prostate enlargement in men can affect urine flow and continence. Add in age-related comorbidities and medications (such as diuretics or drugs that affect cognition or mobility), and the risk of leaking urine increases. Taken together, these changes mean older adults are more likely to lose voluntary bladder control, rather than gain or maintain it. With appropriate management—pelvic floor exercises, scheduled voiding, and treating reversible factors—continence can improve for some, but the general trend with aging is toward decreased control.