Urinary, Fecal, and Dual Incontinence in Older U.S. Adults

Wu JM1, Matthews CA, Vaughan CP, Markland AD. J Am Geriatr Soc. 2015 May 4. doi: 10.1111/jgs.13385. [Epub ahead of print]
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1Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina; Center of Aging and Health, University of North Carolina, Chapel Hill, North Carolina.


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.

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