Overactive bladder (OAB) is a highly prevalent condition among older patients, 
and its presence is associated with the use of substantial healthcare resources 
and economic costs. Within the next 30 years, it is expected that the demand for 
services related to OAB will increase dramatically. Treatment of OAB is 
challenging and depends on several factors, including the age of the patient, 
cognitive functioning, and the degree of mobility. Pharmacotherapy, such as the 
use of tolterodine and oxybutynin, is a viable option for the treatment of OAB, 
and muscarinic antagonists are commonly used. The efficacy of an agent may 
differ in older patients compared with younger ones. In addition, certain side 
effects can be particularly troublesome in the geriatric population. A 
retrospective analysis of a large managed care database showed an age-related 
increase in the number of women seeking care for OAB. Caring for incontinent 
patients in the long-term care setting was shown to result in substantial 
additional costs, which were higher in those with more frequent incontinent 
episodes. Prompted voiding may be effective in reducing the number of 
incontinent episodes for those in institutionalized care; however, this practice 
is labor intensive and generally is only effective in 40% of cases. Moreover, 
assistance with prompted voiding must be maintained continuously. Future 
research should focus on defining the most cost-effective methods of treating 
OAB in the long-term care setting.