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Treatment seeking for urinary incontinence in older adults
K L Burgio1, D G Ives, J L Locher
1Dept of Medicine, University of Alabama, Birmingham School of Medicine 35294-2100.
Objective:
To examine treatment seeking for urinary incontinence among older adults and to identify characteristics associated with treatment-seeking behavior.
Design:
Survey.
Setting:
Five rural counties in northwestern Pennsylvania.
Participants:
1104 community-dwelling ambulatory older adults aged 65 to 79 years with self-reported urinary incontinence. Participants were a subgroup of a large sample (n = 3884) who volunteered for a study of health promotion services. Those who reported urinary incontinence within the past year, during an in-person health risk appraisal, were included in this analysis.
Measurements:
Reporting incontinence to the participant's physician was the main dependent measure.
Main Results:
37.6% of the participants had told their physician about loss of urine. Reporting incontinence to a physician was strongly associated with severity of incontinence as indicated by eight measures (P < 0.001). Treatment seeking was also related to type of incontinence (P < 0.001), physical disability (P < 0.01), and the pattern of health care utilization (P < 0.01). In multiple logistic regression analyses, younger age, physical disability, and frequency of physical and rectal examinations had significant predictive value independent of severity. Not associated with treatment seeking were gender, marital status, income, employment status, educational level, and distance from health care provider.
Conclusions:
The majority of older adults with urinary incontinence do not report the condition to their doctor. Severity of incontinence, physical disability, and a pattern of regular health care utilization appear to be the strongest predictors of treatment-seeking behavior.