[Urinary and fecal incontinence in a community-residing elderly population: prevalence, correlates and prognosis]

To estimate the prevalence and risk factors of urinary and fecal incontinence and examine its prognosis among a community-residing elderly population, a randomly selected sample of 1473 elderly people, aged 65 years and over, living in the City of Settsu, Osaka, was investigated in October 1992. Data was obtained from 1405 for a response rate of 95.4%. The cohort of 1405 was followed for 38 months and follow-up was completed for 1325 (94.3%). The main results were as follows: 1) The prevalence of urinary incontinence of any degree was 9.8% in both sexes, and 8.7% men and 6.6% women admitted to some degree of fecal incontinence. 3.4% and 2.0% of the elderly were daily incontinent in urine and feces, respectively. There was an increasing prevalence of urinary and fecal incontinence with age in both sexes. 2) By univariate analyses, age older than 75 years, low activities of daily living (ADL), stroke, dementia, no participation in social activities, and lack of a perception of having a life worth living were significantly associated with both urinary and fecal incontinence. In the multivariate analyses using logistic regression, age older than 75 years and low ADL were significantly associated with any type of incontinence. Stroke was associated with incontinence less than once a day, while dementia was associated with incontinence more than once a day. 3) From analysis by Kaplan-Meier method and log-rank test, the estimated survival rates were higher among the elderly without incontinence than among those with incontinence, and tended to become low with the increased frequency of incontinence in both urine and feces. 4) From Cox proportional hazards model analysis, less than once daily fecal incontinence and once or more fecal and urinary incontinence daily remained as statistically significant factors associated with survival, controlling for other factors.