Global Prevalence of Urinary Incontinence in Individuals With Dementia: A Systematic Review and Meta-Analysis

Urinary incontinence (UI) is a common and debilitating complication in patients with dementia, significantly impacting quality of life, increasing caregiver burden, and accelerating institutionalization.

Despite numerous studies, reported prevalence estimates vary widely, and a precise global pooled prevalence has not been established.

This systematic review and meta-analysis followed PRISMA guidelines. A comprehensive search of PubMed/MEDLINE, Scopus, and Web of Science was conducted from November to December 2025, without publication year restrictions. Observational studies reporting the point prevalence of UI in dementia patients were included. Two independent reviewers screened studies, extracted data, and assessed methodological quality using the Newcastle-Ottawa Scale. A random-effects meta-analysis (restricted maximum likelihood method) was used to pool prevalence estimates. Heterogeneity was assessed using the I² statistic. Subgroup analyses were performed by setting and UI assessment method, and meta-regression examined associations with Human Development Index (HDI) and temporal trends.

Ten studies comprising 286,544 participants were included. The pooled global prevalence of UI in dementia patients was 39.7% (95% CI: 23.9%-58.1%), with substantial heterogeneity (I² > 95%). Prevalence ranged from 4% in Taiwan to 88% in Japan. Subgroup analyses revealed significantly higher prevalence in clinic/hospital settings compared to community settings (47.5% vs. 28.7%, p = 0.023), and in studies using single-question interviews versus medical record extraction (59.2% vs. 23.2%, p = 0.016). Meta-regression showed a significant positive association with HDI (coefficient: 5.69, p < 0.001). Sensitivity analysis confirmed the robustness of the pooled estimate.

Approximately 40% of dementia patients experience UI, with substantial variation by setting and assessment method. Standardized assessment protocols are needed to inform targeted interventions and reduce disease burden.