title: Nocturnal Enuresis in Older People: Where Is the Evidence and What Are the Gaps?
abstract: While there is extensive literature regarding nocturnal enuresis in children and young adults, relatively little research explores this problem in older people. This scoping review sought to identify knowledge gaps and provide research direction specifically for older, institutionalized adults with nocturnal enuresis. A comprehensive search of 8 electronic databases and the gray literature was undertaken. Studies focusing on the causes, symptoms, and treatment of nocturnal enuresis in older people were retrieved. A broad search strategy including all adults was employed in order to capture all relevant publications. Articles were then excluded by title and abstract such that only those relevant to the older adult and institutionalized populations remained. Relevant articles were identified by title and language. Further reading of the abstract allowed inclusion and a final full reading of the articles allowed all authors to map research activity and identify knowledge gaps. After duplicates and nonrelevant articles were eliminated, we identified 7 articles on nursing home residents and 2 involving older people living in psychiatric institutions. Published literature focused on causes and treatment with either desmopressin or aversive behavioral therapy. No study included a comprehensive continence assessment or controlled for comorbid conditions. Identified gray literature focused on general continence information for the public and nonspecialist clinicians. We conclude that there is a dearth of evidence relevant to this troublesome condition. Gaps in the evidence base include a lack of standardized terminology and limited research focusing on the epidemiology, pathophysiology, and treatment of nocturnal enuresis, all of which suggest a rich research agenda for future investigation.
authors.affiliation: Megan Howlett, BSc, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. William Gibson, MD, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada. Kathleen F. Hunter, PhD, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada; and Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada. Thane Chambers, MLIS, Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada. Adrian Wagg, MD, Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
authors.forename: Megan
authors.initials: M
authors.lastname: Howlett
authors.forename: William
authors.initials: W
authors.lastname: Gibson
authors.forename: Kathleen F
authors.initials: KF
authors.lastname: Hunter
authors.forename: Thane
authors.initials: T
authors.lastname: Chambers
authors.forename: Adrian
authors.initials: A
authors.lastname: Wagg
mesh_terms: D041342:Absorbent Pads; D000368:Aged; D000369:Aged, 80 and over; D001127:Arginine Vasopressin / Q000494:pharmacology / Q000627:therapeutic use; D055317:Evidence-Based Practice / Q000592:standards*; D006801:Humans; D053206:Nocturnal Enuresis / Q000628:therapy*
chemical_list: D001127:Arginine Vasopressin