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.

Objectives 1) To examine relationships between frequency of nocturia and self-reported sleep quality and objective sleep measures in older women and 2) to estimate the amount of variation in sleep measures that is specifically attributable to frequency of nocturia. Design and Setting Secondary, cross sectional analysis of the multicenter prospective cohort Study of Osteoporotic Fractures (SOF) Participants Community-dwelling women aged ≥ 80 years Measurements Frequency of nocturia in the previous 12 months, Pittsburgh Sleep Quality Index sleep quality subscale, and actigraphy-measured wake after sleep onset (WASO) and total sleep time (TST). Results Of 1,520 participants, 25% (N=392) reported their nocturia frequency was 3–4 times/night and an additional 60% (N=917) reported their nocturia frequency was 1–2 times/night. More frequent nocturia was associated with poor sleep quality (3–4/night: 26.8% reported fairly bad or very bad sleep quality; 1–2/night: 14.7%; 0/night: 7.7%; p<.001) and longer WASO (3–4/night: 89.8 minutes; 1–2/night: 70.6; 0/night: 55.5; p<.001). In nested regression models, a nocturia frequency of 3–4/night quadrupled the odds of poor sleep quality (odds ratio: 4.26 [95% CI 1.65, 11.01]; p=.003) and was associated with a 37-minute worsening in WASO (95% CI 26.0, 49.0; p<.001). Frequency of nocturia explained an additional 6% variation in WASO, above and beyond demographic, medical/psychiatric conditions, and medication factors (ΔR2=.06). Conclusions Nocturia is common among octogenarian and nonagenarian women and is independently associated with poor sleep quality and longer wake time at night. Interventions that improve nocturia may be useful in improving sleep quality and wake time at night.