New-onset urinary incontinence in the first six month after admission into a nursing home: Prevalence, incidence and remission, risk and protective factors

Background Urinary incontinence is a common health problem, particularly in nursing homes. However, neither its prevalence at the time of entry nor its incidence in the first six months of residence has been assessed in the German nursing home population. Few studies have been performed to identify risk factors for new-onset urinary incontinence. Possible protective factors have not yet been analyzed for Germany. Aim The study assesses the entry and overall prevalence of urinary incontinence in German nursing homes as well as its incidence during the first six months after entry. It also identifies factors that increase the risk of newonset urinary incontinence after entry as well as those that promote preservation/restoration of the continence capacity. Method A secondary analysis (cross-section and longitudinal section) was conducted to examine resident-related data recorded by the electronic health care documentation system of a provider with 47 nursing homes. The random sample comprised 2466 (cross-section) and 2000 persons (longitudinal section). Results Urinary incontinence was seen in 79.5% of residents at the time of entry. Its prevalence rose to 83% after six months. The overall prevalence was 87.3% (2153 of 2466). Bivariate analysis showed a disproportionately high incidence of newonset urinary incontinence among residents with adequate physical and mental resources and low care needs at the time of entry. Constructing course variables in the bivariate analysis revealed that new-onset urinary incontinence correlated highly with deterioration of the overall physical constitution, the ability to walk and move, and the mental condition, whereas restoration of the continence capacity was clearly associated with improvement in these areas. Conclusions The results show that preserving and promoting the mental and physical capacities of residents are the most important preventive and rehabilitating measures for counteracting the development of incontinence after nursing home entry.