What age-related change contributes to urinary incontinence in older adults?

• A. Decreased bladder muscle tone
• B. Increased bladder capacity
• C. Increased bladder sensation
• D. Decreased urethral sphincter tone

Answer: (A)

As people age, the bladder’s smooth muscle (the detrusor) often loses some tone and contractile strength. This weaker detrusor makes it harder for the bladder to hold urine reliably and to contract effectively when it’s time to void, so small amounts can leak and contribute to incontinence. In aging, the bladder tends to store urine less effectively, and leakage can occur more easily as it fills.

Other options don’t fit typical age-related changes: bladder capacity generally doesn’t increase with age (it tends to stay the same or decrease), bladder sensation often becomes blunted rather than heightened, and while weaker urethral sphincter tone can cause leakage, the most consistent age-related change linked to incontinence is reduced detrusor muscle tone.