Clinical profile of elderly urinary incontinence in Singapore: a community-based study

The prevalence of urinary incontinence in the elderly aged 65 years and above was found to be 4.6% (42 out of a total of 919 respondents), in a community-based study in Singapore. Urinary incontinence was defined as leakage of urine on at least two occasions in the previous one month. The clinical profile of 30 out of the 42 (71%) subjects were studied. There was equal distribution of male and female subjects. Eighteen (60%) of the subjects were below 75 years of age. Twenty-five (83.3%) subjects had severe incontinence. Twenty-four (80%) had the incontinence for more than one year. Despite the high percentage of patients with severe incontinence, only nine (30%) used some form of aid. Incontinence in our very old (75 years and above) was not related to frailty or physical dependence. Seven of the subjects (23.3%) were found to have functional incontinence associated with cognitive impairment. These patients were unable to indicate their toilet needs. They also had associated physical disability as well as double incontinence, and their carers were under stress. Ten of the subjects had pure urge incontinence. Seven of them had an underlying central nervous system disorder, suggesting that destrusor hyperreflexia may be the underlying cause for urinary incontinence in this group. All except one in this group had more than one possible precipitating factor for their incontinence. Eleven subjects had symptoms suggestive of outlet obstruction, although only two were found to have proven outlet obstruction. None of the female subjects had pure stress incontinence.(ABSTRACT TRUNCATED AT 250 WORDS)