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Continence across Continents to Upend Stigma and Dependency (CACTUS-D) Trial

Almost 40% of women aged 65 year and older experience urinary incontinence, but only about 15% seek medical care for the problem. When continence difficulties begin, women often feel embarrassed and ashamed. This shame and embarrassment discourages women from consulting their doctor about the problem.

Absorbent products are the most common way of coping but concerns about pads being noticeable under clothes, pad leakage and odor can cause worry and stress to the wearer. It is therefore common for older women with incontinence to become less outgoing and they may even withdraw from social participation.

Difficulties coping with continence needs are a major factor in the decision to enter residential care. The CACTUS-D trial was designed to test the benefit of a continence promotion program that aims to reduce incontinence symptoms, reduce falls and eliminate stigma among older community-dwelling women in Quebec, Western Canada, France and the UK. 

This multinational project also evaluated the cost of the continence promotion in the different countries so that health providers can see the value for money associated with this proactive approach to one of the most common but unseen barriers to active, healthy ageing.

The Trial Protocol is available here.

Results highlights are available here.


See PowerPoint presentation about continence

See PowerPoint presentation about aging well

Video: Dare to Age well Workshop on Continence

Video: Dare to Age Well Workshop


The Cactus-D trial is jointly funded by:


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