Incontinence is prevalent among older Americans across a range of living arrangements, new national data indicate.

Incontinence, both bladder and bowel, represents a significant financial burden to the individual and society, Yelena Gorina, MS, MPH, and colleagues from the National Center for Health Statistics (NCHS) note in a report released today. Incontinence also exacts a high emotional toll in terms of shame and embarrassment, as well as discomfort and life disruption. Incontinence has been linked to declining mental health and increased risk for the onset of psychological distress and depressive symptoms and is also a predictor of functional limitations, which may lead to falls, injuries, and mobility impairment.

The report released today is the first to present national estimates of incontinence for subpopulations of Americans aged 65 years and older sampled by NCHS surveys and the Centers for Medicare & Medicaid Long Term Care Minimum Data Set, the authors note. The findings are based on interviews with 2625 noninstitutionalized persons and reports by staff for 6856 residents of residential care facilities, 3226 current home healthcare patients, 3918 hospice patients, and more than 2.4 million nursing home residents.

Half of Community-Dwelling Older Adults Incontinent

Among the noninstitutionalized individuals, 50.9% reported a urinary leakage and/or accidental bowel leakage of mucus, liquid stool, or solid stool; 43.8% reported a urinary leakage, and 17.3% reported an accidental bowel leakage. Incontinence was more common in women than men, particularly non-Hispanic white women.

Among residential care facility residents, 39.0% had an episode of urinary and/or bowel incontinence during the last week: 36.6% reported leaked urine and 20.4% reported bowel incontinence. Women were more likely than men to be incontinent of bladder, but there was no sex difference in bowel incontinence.

Roughly 45% of home healthcare patients and 62% of hospice care patients reported difficulty controlling their bladder and/or bowels. The same was true for 46.1% of short-term nursing home residents and 75.8% of long-term nursing home residents.

“Because a different definition of incontinence is used by each data collection system, it is not possible to make data comparisons between surveys or to summarize results across all surveys,” the authors say.

Nonetheless, including recent data from all of these data collection systems “facilitates a multidimensional picture of incontinence, while underscoring the need for a standardized definition,” they conclude.

“Prevalence of Incontinence Among Older Americans.” NCHS. Published online June 25, 2014. Full text

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