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Incontinence in persons with Down Syndrome.

Justine Niemczyk1, Alexander von Gontard1, Monika Equit2

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Summary

Incontinence is common in young children with Down syndrome, decreasing in adolescence but rising again in older adults. Behavioral issues are linked to incontinence in adults with Down syndrome.

Keywords:
Down Syndromeenuresisfecal incontinencepsychopathologyurinary incontinence

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Area of Science:

  • Genetics and Developmental Pediatrics
  • Clinical Psychology and Behavioral Health

Background:

  • Down syndrome, a genetic condition resulting from trisomy 21, is associated with intellectual disability and distinct physical features.
  • Incontinence and associated psychological challenges are frequently observed in individuals with Down syndrome, impacting quality of life.

Purpose of the Study:

  • To determine the prevalence of incontinence (nocturnal enuresis, daytime urinary, and fecal incontinence) in individuals with Down syndrome across different age groups.
  • To investigate the association between incontinence and psychological problems, specifically behavioral comorbidities, in this population.

Main Methods:

  • A cohort of 317 individuals with Down syndrome (aged 4-51 years) was recruited via a German parent support group.
  • Validated questionnaires, including the Parental Questionnaire: Enuresis/Urinary Incontinence, Incontinence Questionnaire-Pediatric Lower Urinary Tract Symptoms, and Developmental Behavior Checklist (DBC), were utilized.

Main Results:

  • Prevalence rates included 17.2% nocturnal enuresis, 15.9% daytime urinary incontinence, and 14.2% fecal incontinence.
  • Incontinence was highest in young children (64.0%) and older adults (>30 years, 22.4%), with lower rates in teens (10.3%) and young adults (12.8%).
  • Clinical DBC scores were found in 13.6% of children and 8.4% of adults; behavioral problems were more common in incontinent adults (27.8%) and significantly associated with nocturnal enuresis and daytime urinary incontinence.

Conclusions:

  • Incontinence in Down syndrome exhibits a bimodal distribution, prevalent in early childhood and increasing again in older adulthood.
  • Behavioral comorbidities are significantly associated with incontinence specifically in adults with Down syndrome.
  • Routine screening and timely intervention for incontinence are recommended for individuals with Down syndrome.