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A 10-Year Follow-Up of Urinary and Fecal Incontinence among the Oldest Old in the Community: The Canadian Study of Health and Aging

Published online by Cambridge University Press:  31 March 2010

Truls Østbye ,
Arnfinn Seim ,
Katrina M. Krause ,
John Feightner ,
Vladimir Hachinski ,
Elizabeth Sykes  and
Steinar Hunskaar
Truls Østbye*
Affiliation:
Duke University Medical Center, Durham, NC
Arnfinn Seim
Affiliation:
Norwegian University of Science and Technology, Trondheim, Norway
Katrina M. Krause
Affiliation:
Duke University Medical Center, Durham, NC
John Feightner
Affiliation:
University of Western Ontario, London, ON
Vladimir Hachinski
Affiliation:
University of Western Ontario, London, ON
Elizabeth Sykes
Affiliation:
University of Ottawa, Ottawa, ON
Steinar Hunskaar
Affiliation:
University of Bergen, Bergen, Norway
*
Requests for offprints should be sent to: / Les demandes de tirés-à-part doivent être adressées à : Truls Ø;stbye, Department of Community and Family Medicine, Box 2914, Duke University Medical Center, Durham, NC 27713. (truls.ostbye@duke.edu)
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Abstract

Urinary incontinence is common in the elderly. The epidemiology of fecal and double (urinary and fecal) incontinence is less known. The Canadian Study of Health and Aging (CSHA) is a national study of elderly living in the community at baseline (n = 8,949) and interviewed in 1991–1992, 1996, and 2001. Using data from the CSHA, we report the prevalence of urinary, fecal, and double incontinence in each wave and the cumulative incidence between waves and investigate the predictors of urinary and fecal incontinence. Urinary incontinence increased rapidly in old age, being almost twice as high in women as in men. Fecal and double incontinence were less common, but also increased rapidly with age. In women, parity showed a positive relationship with (prevalent) urinary incontinence. In men, diabetes was a risk factor for urinary and fecal incontinence. We conclude that urinary, fecal, and double incontinence increase rapidly with age and that inquiry about incontinence should be part of routine medical and nursing assessment of all elderly.

Résumé

L'incontinence urinaire est un phénomène fréquent chez les personnes âgées. Toutefois, l'épidémiologie de l'incontinence fécale et de l'incontinence double (urinaire et fécale) est moins connue. L'Étude sur la santé et le vieillissement au Canada (ÉSVC) est une étude nationale menée auprès d'un échantillon-témoin de personnes âgées résidant dans la communauté (n = 8 949) et ayant participé à des entrevues en 1991–1992, 1996 et 2001. Nous avons examiné, à partir des données de l'ÉSVC, la prévalence de l'incontinence urinaire, fécale et double au cours de chaque cycle, ainsi que l'incidence cumulative entre les cycles, et recherché les prédicteurs de l'incontinence urinaire et fécale. L'incontinence urinaire augmente rapidement avec l'âge et est près de deux fois plus fréquente chez les femmes que chez les hommes. L'incontinence fécale et l'incontinence double sont moins courantes, mais augmentent elles aussi rapidement avec l'âge. Chez les femmes, la parité (le nombre d'enfants mis au monde) influe sur l'incontinence urinaire (prévalente). Chez les hommes, le diabète est un facteur de risque d'incontinence urinaire et fécale. Nous en concluons que l'incontinence urinaire, l'incontinence fécale et l'incontinence double augmentent rapidement avec l'âge et que la question devrait être systématiquement explorée lors de l'examen médical et de l'évaluation infirmière de routine des personnes âgées.

Keywords

agingurinary incontinencefecal incontinencedouble incontinenceincidencerisk factorslongitudinal studyvieillissementincontinence urinaireincontinence fécaledouble incontinenceincidencefacteurs de risqueétude longitudinale
Type
Articles
Information
Canadian Journal on Aging / La Revue canadienne du vieillissement , Volume 23 , Issue 4 , Winter/Hiver 2004 , pp. 319 - 331
Copyright
Copyright © Canadian Association on Gerontology 2004

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References

1Swithinbank, LV, Abrams, P. The impact of urinary incontinence on the quality of life of women. World J Urol 1999;17:225–229.CrossRefGoogle ScholarPubMed
2Perry, S, Shaw, C, McGrother, C, Matthews, C, Assassa, RJ, Dallosso, J, et al. Prevalence of faecal incontinence in adults aged 40 years or more living in the community. Gut 2002;50:480–484.CrossRefGoogle ScholarPubMed
3Wilson, L, Brown, JS, Shin, G, Luc, KO, Subak, LL. Annual direct cost of urinary incontinence. Obstet Gynecol 2001;98:398–406.Google ScholarPubMed
4Langa, KM, Fultz, NH, Saint, S, Kabeto, MU, Herzog, AR. Informal caregiving time and costs for urinary incontinence in older individuals in the United States. J Am Geriatr Soc 2002;50:733–737.CrossRefGoogle ScholarPubMed
5Edwards, NI, Jones, D. The prevalence of faecal incontinence in older people living at home. Age Ageing 2001;30:503–507.CrossRefGoogle ScholarPubMed
6Seim, A, Sandvik, H, Hermstad, R, Hunskaar, S. Female urinary incontinence—consultation behaviour and patient experiences: an epidemiological survey in a Norwegian community. Fam Pract 1995;12:18–21.CrossRefGoogle Scholar
7Hannestad, YS, Rortveit, G, Hunskaar, S. Help-seeking and associated factors in female urinary incontinence. The Norwegian EPINCONT Study. Scand J Prim Health Care 2002;20:102–107.CrossRefGoogle ScholarPubMed
8Seim, A, Sivertsen, B, Eriksen, BC, Hunskaar, S. Treatment of urinary incontinence in women in general practice: observational study. BMJ 1996;312:1459–1462.CrossRefGoogle ScholarPubMed
9Schnelle, JF, Alessi, CA, Simmons, SF, Al-Samarrai, Nr, Beck, JC, Ouslander, JG. Translating clinical research into practice: a randomized controlled trial of exercise and incontinence care with nursing home residents. J Am Geriatr Soc 2002;50:1476–1483.CrossRefGoogle Scholar
10Chassagne, P, Jego, A, Gloc, P, Caet, C, Trivalle, C, Doucet, J, et al. Does treatment of constipation improve faecal incontinence in institutionalized elderly patients? Age Ageing 2000;29:159–164.CrossRefGoogle ScholarPubMed
11Borrie, MJ, Bawden, M, Speechley, M, Kloseck, M. Interventions led by nurse continence advisers in the man agement of urinary incontinence: a randomized controlled trial. CMAJ 2002;166(10):1267–1273.Google Scholar
12Thom, D. Variation in estimates of urinary incontinence prevalence in the community: effects of differences in definition, population characteristics, and study type. J Am Geriatr Soc 1998;46:473–480.CrossRefGoogle ScholarPubMed
13Hunskaar, S, Arnold, EP, Burgio, K, Diokno, AC, Herzog, AR, Mallett, VT. Epidemiology and natural history of urinary incontinence. Int Urogynecol J Pelvic Floor Dysfunct 2000;11:301–319.CrossRefGoogle ScholarPubMed
14Hannestad, YS, Rortveit, G, Sandvik, H, Hunskaar, S. A community-based epidemiological survey of female urinary incontinence: the Norwegian EPINCONT study. J Clin Epidemiol 2000;53:1150–1157.CrossRefGoogle ScholarPubMed
15Parazzini, F, Lavezzari, M, Artibani, W. Prevalence of overactive bladder and urinary incontinence. J Fam Pract 2002;51:1072–1075.Google ScholarPubMed
16Holtedahl, K, Hunskaar, S. Prevalence, 1-year incidence and factors associated with urinary incontinence: a population based study of women 50–74 years of age in primary care. Maturitas 1998;28:205–211.CrossRefGoogle ScholarPubMed
17Herzog, AR, Diokno, AC, Brown, MB, Normolle, DP, Brook, BM. Two-year incidence, remission, and change patterns of urinary incontinenœ in noninstitutionalized older adults. J Gerontol 1990;45:M67–M74.CrossRefGoogle ScholarPubMed
18Nygaard, IE, Lemke, JH. Urinary incontinence in rural older women: prevalence, incidence and remission. J Am Geriatr Soc 1996;44:1049–1054.CrossRefGoogle ScholarPubMed
19Møller, LA, Lose, G, Jørgensen, T. Incidence and remission rates of lower urinary tract symptoms at one year in women aged 40–60: longitudinal study. BMJ 2000;320:1429–1432.CrossRefGoogle ScholarPubMed
20Nakanishi, N, Tatara, K, Naramura, H, Fujiwara, H, Takashima, Y, Fakuda, H. Urinary and fecal incontinence in a community-residing older population in Japan. J Am Geriatr Soc 1997;45:215–219.CrossRefGoogle Scholar
21Roberts, RO, Jacobsen, SJ, Reilly, WT, Pemberton, JH, Lieber, MM, Talley, NJ. Prevalence of combined fecal and urinary incontinence: a community-based study. J Am Geriatr Soc 1999;47:837–841.CrossRefGoogle ScholarPubMed
22Faltin, DL, Sangalli, MR, Curtin, F, Morabia, A, Weil, A. Prevalence of anal incontinence and other anorectal symptoms in women. Int Urogynecol J Pelvic Floor Dysfunct 2001;12:117–120.CrossRefGoogle ScholarPubMed
23Meschia, M, Buonaguidi, A, Pifarotti, P, Somigliana, E, Spennacchio, M, Amircarelli, F. Prevalence of anal incontinence in women with symptoms of urinary incontinence and genital prolapse. Obstet Gynecol 2002;100:719–723.Google ScholarPubMed
24The Canadian Study of Health and Aging Working Group. Canadian Study of Health and Aging: study methods and prevalence of dementia. CMAJ 1994;150:899–913.Google Scholar
25Hunskaar, S, Østbye, T, Borrie, MJ. Prevalence of urinary incontinence in elderly Canadians with special emphasis on the association with dementia, ambulatory function, and institutionalization. Norwegian J Epidemiol 1998;8:177–182.Google Scholar
26Østbye, T, Hunskaar, S, Sykes, L. Predictors and incidence of urinary incontinence in elderly Canadians with and without dementia—a 5 year follow up: The Canadian Study of Health and Aging. Can J Aging 2002;21:95–101.CrossRefGoogle Scholar
27The Canadian Study of Health and Aging Working Group. Patterns of caring for persons with dementia in Canada: The Canadian Study of Health and Aging. Can J Aging 1994;13:470–487.CrossRefGoogle Scholar
28The Canadian Study of Health and Aging Working Group. The incidence of dementia in Canada. Neurology 2000;55:66–73.CrossRefGoogle Scholar
29Teng, EL, Chui, HC. The Modified Mini-Mental State (3MS) examination. J Clin Psychiatry 1987;48:314–318.Google ScholarPubMed
30Thom, DH, van den Eeden, SK, Brown, JS. Evaluation of parturition and other reproductive variables as risk factors for urinary incontinence in later life. Obstet Gynecol 1997;90:983–989.CrossRefGoogle ScholarPubMed
31Teasdale, TA, Taffet, GE, Luchi, RJ, Adam, E. Urinary incontinence in a community-residing elderly population. J Am Geriatr Soc 1988;36:600–606.CrossRefGoogle Scholar
32Rortveit, G, Hannestad, YS, Daltveit, AK, Hunskaar, S. Age- and type-dependent effects of parity on urinary incontinence: the Norwegian EPINCONT study. Obstet Gynecol 2001;98:1004–1010.Google ScholarPubMed
33Chiarelli, P, Brown, W, McElduff, P. Leaking urine: prevalence and associated factors in Australian women. Neurourol Urodyn 1999;18:567–577.3.0.CO;2-F>CrossRefGoogle ScholarPubMed
34Aggazzotti, G, Pesce, F, Grassi, D, Fantuzzi, G, Righi, E, DeVita, D, et al. Prevalence of urinary incontinence among institutionalized patients: a cross-sectional epidemiologic study in a midsized city in northern Italy. Urology 2000;56:245–249.CrossRefGoogle Scholar
35Landi, F, Cesari, M, Russo, A, Onder, G, Lattanzio, F, Bernabei, R, et al. Potentially reversible risk factors and urinary incontinence in frail older people living in community. Age Ageing 2003;32:194–199.CrossRefGoogle ScholarPubMed
36Pannek, J, Haupt, G, Sommerfeld, HJ, Schulze, H, Senge, T. Urodynamic and rectomanometric findings in urinary incontinence. Scand J Urol Nephrol 1996;30:457–460.CrossRefGoogle ScholarPubMed
37Chassagne, P, Landrin, I, Neveu, C, Czernichow, P, Bouaniche, M, Doucet, J, et al. Fecal incontinence in the institutionalized elderly: incidence, risk factors, and prognosis. Am J Med 1999;106:185–190.CrossRefGoogle ScholarPubMed
38Harari, D, Coshall, C, Rudd, AG, Wolfe, CD. New-onset fecal incontinence after stroke: prevalence, natural history, risk factors, and impact. Stroke 2003;34:144–150.CrossRefGoogle Scholar
39Jackson, SL, Weber, AM, Hull, TL, Mitchinson, AR, Walters, MD. Fecal incontinence in women with urinary incontinence and pelvic organ prolapse. Obstet Gynecol 1997;89:423–427.CrossRefGoogle ScholarPubMed
40Resnick, NM, Beckett, LA, Branch, LG, Scherr, PA, Wetle, T. Short-term variability of self-report of incontinence in older persons. J Am Geriatr Soc 1994;42:202–207.CrossRefGoogle ScholarPubMed