Urinary and fecal incontinence in a community-residing older population in Japan

OBJECTIVE: To estimate the prevalence and risk factors of urinary and fecal incontinence among a community-residing older population in Japan. DESIGN: Population-based cross-sectional study. SUBJECTS: A randomly selected sample of 1473 people aged 65 years and older living in the City of Settsu, Osaka, in 1992. MEASURES: Data collected via in-home visits were used to estimate the prevalence of urinary and fecal incontinence and to provide information regarding potential risk factors of urinary and fecal incontinence. RESULTS: Data were obtained from 1405 older adults, a response rate of 95.4%. The prevalence of any degree of urinary incontinence was 98/1000 in both sexes, and 87/1000 men and 66/1000 women admitted to some degree of fecal incontinence. Daily, 34/1000 and 20/1000 of the population were incontinent of urine and feces, respectively. There was an increasing prevalence of urinary and fecal incontinence with age in both sexes, but the expected greater prevalence in women was not found. By univariate analyses, age older than 75 years, poor general health as measured by Activities of Daily Living, stroke, dementia, no participation in social activities, and lack of life worth living (IKigai) were associated significantly with both urinary and fecal incontinence. In the multivariate analyses using logistic regression, age older than 75 years, poor general health, and stroke were independent risk factors for any type of incontinence. Diabetes was an independent risk factor for isolated fecal incontinence, and dementia and no participation in social activities were independent risk factors for double incontinence. CONCLUSIONS: Incontinence of urine and feces is a prevalent condition among very old people living in the community in Japan and is associated highly with health and psychosocial conditions.