Brain scans reveal why bladder control fails with age

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: * 'Old' (community-dwelling, mentally and functionally intact ambulatory women aged 65+ years) or 'Young' (equivalent women aged 18-45) * 'Wet' (those who meet the International Continence Society definition of urgency urinary incontinence (urinary leakage accompanied by a sudden, strong urge to void which is difficult to defer) \>5 times per week, for 3 months despite treatment for reversible causes (e.g., Urinary tract infection) and confirmed by a mean of one episode per day of UUI on 3-day bladder diary) or 'Dry' (women without current or past UUI or other lower urinary tract symptoms.) Infrequent stress incontinence of a small amount is acceptable. * Urge-predominant mixed incontinence is acceptable provided the subject is able to differentiate between stress incontinence (SUI - leakage that coincides instantaneously with cough, laugh, exercise) and urgency incontinence, i.e., leakage accompanied by a sudden strong urge to void that is difficult to defer. * Those with current or previous use of anticholinergic/beta-3 agonist medications will be considered for the study if they are willing to go through a washout period of at least 4 weeks of duration. Exclusion Criteria: Dry Groups * Current or prior treatment for UUI * Leakage on bladder diary not ascribed to minimal SUI (see bullet above) All Groups: 'Wet' or 'Dry'; 'Young' or 'Old' * Cognitive impairment: * MoCA\<26 * inability to perform a voiding diary/pad test * inability to reliably take daily medication * inability to comply with fMRI testing * Impaired mobility o Timed up and go test ≥ 12 secs * Medical instability: * severe uncontrolled hypertension \>180mmHg systolic or \>100mmHg diastolic * potential major changes in medical management over the course of the study period (i.e. upcoming surgery/treatment) * frailty according to the Fried criteria * MRI incompatibility: * contraindicated metal implants * claustrophobia * unidentified/untested compatibility of metal implants * Medication incompatibility: * allergy to study medication (all prophylactic antibiotic choices) * interaction of prophylactic antibiotic choices with current medications * expected change in medication during the study * Neurological conditions: * spinal cord injury; * multiple sclerosis * clinically apparent lesions (e.g. lacunae associated with stroke) * prior stroke * Parkinson's Disease/ALS/MSA * any clinically apparent neurological condition * Lower urinary tract comorbidities/treatment: * history of pelvic irradiation * bladder or advanced uterine cancer * possible urethral obstruction (advanced prolapse \[POP-Q\>II\] or Qmax\<12 ml/s on free flow) * urinary retention (PVR \>200 ml) * Interstitial Cystitis/Bladder Pain Syndrome * artificial sphincter implant * Botox treatment for UUI within 1 year * Neuromodulation treatment for UUI * Other comorbidities: * uncontrolled depression (PHQ-9 ≥10)