Prevalence of and factors associated with fecal incontinence in a large community study of older individuals

Objectives: In this study, we describe the prevalence of fecal incontinence by race, age, sex, the presence of major chronic conditions of stroke and diabetes, and the use of certain psychoactive medications. Methods: Study subjects are participants in the Chicago Health and Aging Project, a study of older Chicago residents of a geographically defined area. In the period 1993-1996, interviewers conducted a door-to-door census that identified 6,099 individuals who participated in in-home interviews. The interviews included a wide range of questions regarding demographics, medical history, and medication use. The question used to determine the presence of fecal incontinence was: "In the past few months have you ever lost control of your bowels when you didn't want to?" Results: Fecal incontinence was seen in 585 of 6,099 survey responders yielding an overall prevalence of 9.6%. The prevalence of fecal incontinence was strongly associated with age across all demographic groups. We did not observe significant differences in the prevalence for males and females once we adjusted for age. However, the increase in prevalence with age was significantly greater among Blacks than Whites. The use of psychoactive medications was found to be associated with significantly higher odds of fecal incontinence. Diabetes and stroke were associated with a higher prevalence of fecal incontinence. Conclusions: These cross-sectional analyses offer promising evidence that this common condition is correlated with the presence of certain conditions (e.g., stroke and diabetes) and use of certain psychoactive medications.