Fecal incontinence in Wisconsin nursing homes: prevalence and associations

This report determines the characteristics and health histories that are associated with fecal incontinence in a nursing home population.

A cross-sectional survey is reported comprised of data from the Health Care Finance Administration's Minimum Data Set submitted by Wisconsin skilled nursing facilities to the Wisconsin Center for Health Statistics' Annual Nursing Home Survey in 1992 and 1993. Demographic characteristics, functional status, and disease history were correlated with the dependent variable, fecal incontinence.

In both 1992 and 1993, significant positive associations with fecal incontinence included the following, in order of adjusted odds ratios: urinary incontinence, tube feeding, any loss of activities of daily living, diarrhea, truncal restraints, pressure ulcers, dementia, impaired vision, fecal impaction, constipation, male gender, age, and increasing body mass index. Significant inverse associations were noted for heart disease and depression in one of the years and arthritis in both years. In both years, diabetes was not associated with fecal incontinence.

Urinary incontinence frequently coexists with fecal incontinence. The treatment of fecal incontinence may depend more on awareness of these significant associations, such as tube feeding, impaction, diarrhea, and loss of activities of daily living, which might exacerbate fecal incontinence, than on the condition of the anal sphincter.