Lower urinary tract symptoms and urinary incontinence are highly prevalent in older persons. The physiological changes which occur in the ageing lower urinary tract, combined with neurological alterations in control of continence and micturition conspire to impair control of continence in older persons. In addition to the impact of coexisting medical comorbidities and lower urinary tract disease, this makes urinary incontinence and the ability to successfully toilet a typical geriatric syndrome, requiring multicomponent intervention to achieve the best possible outcome. There are emerging data on the efficacy of treatments in older and frail older persons which, if appropriately applied with regard to the individual, should result in amelioration of symptoms and bother, or socially contained continence for the most medically complex older person.