Urinary, Fecal, and Dual Incontinence in Older US Adults

• Authors: Jennifer M. Wu, University of North Carolina; Catherine A. Matthews, University of North Carolina; Camille Vaughan, Emory University; Alayne D. Markland, University of Alabama Birmingham
• Journal Title: Journal of the American Geriatrics Society
• Volume: Volume 63, Number 5
• Publisher: Wiley: 12 months | 2015-05-01, Pages 947-953
• Type of Work: Article | Post-print: After Peer Review
• Publisher DOI: http://doi.org/10.1111/jgs.13385
• Subjects: Health Sciences, Medicine and Surgery
• Keywords: Science & Technology; Life Sciences & Biomedicine; Geriatrics & Gerontology; Gerontology; dual incontinence; fecal incontinence; older adults; urinary incontinence; PELVIC FLOOR DISORDERS; RISK-FACTORS; PREVALENCE; POPULATION; SEVERITY

Abstract

Objectives To estimate the prevalence of urinary (UI), fecal (FI), and dual incontinence (DI) and to identify shared factors associated with each type of incontinence in older U.S. women and men. Design Population-based cross-sectional study. Setting National Health and Nutrition Examination Survey (NHANES, 2005-2010). Participants Women and men aged 50 and older. Measurements UI was defined as moderate to severe (≥3 on a validated UI severity index, range 0-12); FI was at least monthly loss of solid, liquid, or mucus stool; and DI was the presence of UI and FI. Results Women were more likely than men to report UI only and DI but not FI only (UI only, women 19.8%, men 6.4%; FI only, women 8.2%, men 8.4%; DI women, 6.0%, men 1.9%). In both sexes, prevalence increased with age. In regression models adjusted for parity and hysterectomy, DI in women was associated with non-Hispanic white race (odds ratio (OR) = 2.3, 95% confidence interval (CI) = 1.5-3.4), depression (OR = 4.7, 95% CI = 2.0-11.1), comorbidities (OR = 4.3, 95% CI = 1.9-9.6 for ≥3 comorbidities vs none), hysterectomy (OR = 1.8, 95% CI = 1.2-2.7), and diarrhea (OR = 2.8, 95% CI = 1.5-5.0). In men, ADL impairment (OR = 2.4, 95% CI = 1.2-4.9) and poorer self-rated health (OR = 2.8, 95% CI = 1.5-5.30) were associated with DI. Conclusion UI, FI, and DI are common in older women and men. Factors associated with DI were distinct from those associated with UI and FI. There were also differences according to sex, with DI associated with depression and comorbid diseases in women and lack of functional ability and poorer self-rated health in men.