Incontinence in the elderly: prevalence and prognosis

Area of Science:

• Gerontology
• Epidemiology
• Urology

Background:

• Urinary incontinence (UI) is a prevalent condition in the elderly population.
• Factors such as age, dementia, and frailty are associated with UI.
• Faecal incontinence (FI) also affects a significant portion of this demographic.

Purpose of the Study:

• To determine the prevalence of urinary and faecal incontinence in individuals aged 65 and over.
• To investigate the association between incontinence and cognitive function.
• To examine the impact of incontinence on mortality rates in the elderly.

Main Methods:

• A cross-sectional study involving a randomly selected sample of 559 community-dwelling and institutionalized subjects aged 65 years and over.
• Prevalence rates for UI and FI were calculated.
• A three-year follow-up review was conducted to assess mortality in incontinent versus continent individuals.

Main Results:

• The prevalence of UI was 11.6% in those aged 65+, rising to 21.7% in those 80+.
• Dementia and confusion were strongly associated with incontinence, particularly in the oldest age group.
• The prevalence of FI was estimated at 3.1% for individuals 65+.
• Mortality rates were significantly higher for incontinent individuals (73.5% died) compared to continent individuals (34.9% died) after three years.

Conclusions:

• Urinary incontinence is common in older adults, with prevalence increasing with age and in those with cognitive impairment.
• Incontinence in the elderly is often multifactorial, associated with frailty and confusion.
• Urinary incontinence is a significant risk factor for increased mortality in the elderly, necessitating individualized assessment and management strategies.