Geriatric Continence Center

The Continence Research Center at the University of Pittsburgh is a leading hub for translational research focused on understanding and treating urinary symptoms in older adults. Co-directed by Becky Clarkson, PhD, and Shachi Tyagi, MD, the Center brings together expertise in neuroscience, geriatrics, and behavioral medicine to address the complex interplay between the brain, bladder, sleep, and aging. Its mission is to uncover the mechanisms that drive incontinence and related disorders and to translate those findings into innovative, effective therapies that enhance the independence and quality of life of older adults.

Dr. Clarkson’s research examines the role of the brain in bladder control using advanced functional MRI and other neuroimaging tools to characterize how aging alters neural pathways involved in continence. Her NIH-funded studies investigate urgency urinary incontinence (UUI) as a disorder of brain–bladder control rather than solely a bladder-based condition, identifying distinct neural phenotypes that may predict response to behavioral therapies such as biofeedback. Building on these discoveries, her work explores how environmental cues, mindfulness training, and noninvasive brain stimulation techniques can retrain or strengthen brain circuits that regulate continence.

Complementing this work, Dr. Tyagi’s research focuses on the intersection of sleep and urinary health, particularly the causes and consequences of nocturia in older adults. Through the Sleep and Bladder Study, her team is investigating how sleep loss and circadian rhythm disruption affect brain regions involved in bladder control, including the medial prefrontal cortex. The study is testing a combined treatment approach using standard pharmacotherapy with behavioral sleep interventions to improve urinary symptoms, sleep quality, and overall well-being.

Together, Drs. Clarkson and Tyagi lead a vibrant, multidisciplinary program that integrates neurobiology, sleep medicine, and geriatrics to redefine how incontinence is understood and managed, paving the way for brain-based, personalized therapies for older adults.