Frailty is a sneaky beast, encompassing a state of low energy, weakness, and inactivity that can creep in slowly with age. But even before that trajectory begins, you could be dealing with a subtle risk factor, particularly if you’re a woman: urinary incontinence, or loss of bladder control.
Pee leakage is twice as common in women versus men—affecting up to 60% of women in the US—because of factors like pregnancy, childbirth, and the hormone changes of menopause. All of the above can have trickle-down effects on the pelvic floor and bladder.
No matter the trigger, unexpected leaks can hinder your ability to stay active as you age. The result is a faster track to frailty: “The less you move, the less you’re going to be able to move,” Karyn Eilber, MD, a Los Angeles-based urogynecologist and member of the plusOne wellness collective, tells SELF. And becoming frail doesn’t just increase your risk for a disabling fall; it makes you likelier to get sick or even die younger.
Read on to learn why urinary incontinence can contribute to frailty with age and how to get ahead of the downward spiral.
How pee leakage can increase your risk of frailty later in life
There are two main types of urinary incontinence, which can have various effects on your strength as you age. Stress urinary incontinence (SUI) involves dribbling when you laugh, cough, or jump. It happens when weak or damaged pelvic floor muscles or ligaments buckle under pressure, Dr. Eilber explains. In some cases, that pelvic muscle collapse can stem from tightness: “With constant gripping, you lose the coordination of those muscles, then gradually, they weaken,” Patty Beers, PT, DPT, a physical therapist and clinic director at Hughston Clinic, in Orlando, tells SELF.
By contrast, urge incontinence, or overactive bladder (OAB), is when you have to pee very frequently and urgently at unexpected times, Savitha Krishnan, MD, a urogynecologist and pelvic floor reconstructive surgeon at Palo Alto Medical Foundation, tells SELF. It spikes in prevalence in women over 60 because it’s tied to age-related neurological changes and shifts in bladder tissue caused by the estrogen loss of menopause, she says.
Where either kind of incontinence can spell trouble for long-term strength is in restricting mobility: If OAB threatens leakage at any given moment, you probably don’t want to stray far from a bathroom. And if SUI causes dribbling while running or jumping, for instance, “you’re going to be less inclined to engage in high-impact exercise,” Dr. Eilber says, which is a crucial type for maintaining muscle and bone mass with age.
