Introduction and Hypothesis <p>Older women with urinary incontinence (UI) have an elevated risk of falling, a phenomenon that may be partly explained by the attentional demands required to manage bladder sensations during mobility. The objective of this study is to determine whether the urge to urinate in older community-dwelling women presenting with a range of UI severity, influences dual-task performance.</p> Methods <p>This cross-sectional observational study included women aged ≥ 65&#xa0;years who completed the Timed Up-and-Go (TUG) test under single-task conditions. They also completed a motor task (coin transfer) and a cognitive task (phonetic verbal fluency) under dual-task conditions. All tasks were performed with no desire to void and desire to void. Urinary incontinence severity was measured using the International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF). Repeated measures analysis of variance (ANOVA) compared dual-task effects across bladder conditions. Kendall’s correlation examined associations between UI severity and TUG test performance. Forty-two women (72.90 ± 5.81&#xa0;years) with varying degrees of UI participated.</p> Results <p>The desire-to-void condition significantly impaired gait performance. Dual-task effects were greater during the desire-to-void state than during the no-desire-to-void state across motor and cognitive tasks (<i>p</i> &lt; 0.01). Neither TUG test performance nor dual-task effects correlated significantly with ICIQ-SF scores. These results indicate that bladder sensation, rather than UI severity, contributes to performance differences.</p> Conclusions <p>The desire to void adversely affects dual-task gait performance in older women, regardless of UI severity. Bladder-related attentional demands may impair functional mobility and should be considered during fall-risk assessment and intervention planning for older adults.</p>