Prevalence and correlates of fecal incontinence in community-dwelling older adults.
OBJECTIVE
To determine prevalence and correlates of fecal incontinence in older community-dwelling adults.


METHODS
A cross-sectional, population-based survey.


METHODS
Participants interviewed at home in three rural and two urban counties in Alabama from 1999 to 2001.


METHODS
The University of Alabama at Birmingham Study of Aging enlisted 1,000 participants from the state Medicare beneficiary lists. The sample was selected to include 25% black men, 25% white men, 25% black women, and 25% white women.


METHODS
The survey included sociodemographic information, medical conditions, health behaviors, life-space assessment (mobility), and self-reported health status. Fecal incontinence was defined as an affirmative response to the question "In the past year, have you had any loss of control of your bowels, even a small amount that stained the underwear?" Severity was classified as mild if reported less than once a month and moderate to severe if reported once a month or greater.


RESULTS
The prevalence of fecal incontinence in the sample was 12.0% (12.4% in men, 11.6% in women; P=.33). Mean age+/-standard deviation was 75.3+/-6.7 and ranged from 65 to 106. In a forward stepwise logistic regression analysis, the following factors were significantly associated with the presence of fecal incontinence in women: chronic diarrhea (odds ratio (OR)=4.55, 95% confidence interval (CI)=2.03-10.20), urinary incontinence (OR=2.65, 95% CI=1.34-5.25), hysterectomy with ovary removal (OR=1.93, 95% CI=1.06-3.54), poor self-perceived health status (OR=1.88, 95% CI=1.01-3.50), and higher Charlson comorbidity score (OR=1.29, 95% CI=1.07-1.55). The following factors were significantly associated with fecal incontinence in men: chronic diarrhea (OR=6.08, 95% CI=2.29-16.16), swelling in the feet and legs (OR=3.49, 95% CI=1.80-6.76), transient ischemic attack/ministroke (OR=3.11, 95% CI=1.30-7.41), Geriatric Depression Scale score greater than 5 (OR=2.83, 95% CI=1.27-6.28), living alone (OR=2.38, 95% CI=1.23-4.62), prostate disease (OR=2.29, 95% CI=1.04-5.02), and poor self-perceived health (OR=2.18, 95% CI=1.13-4.20). The following were found to be associated with increased frequency of fecal incontinence in women: chronic diarrhea (OR=6.39, 95% CI=2.25-18.14), poor self-perceived health (OR=5.37, 95% CI=1.75-16.55), and urinary incontinence (OR=4.96, 95% CI=1.41-17.43). In men, chronic diarrhea (OR=5.38, 95% CI=1.77-16.30), poor self-perceived health (OR=3.91, 95% CI=1.39-11.02), lower extremity swelling (OR=2.86, 95% CI=1.20-6.81), and decreased assisted life-space mobility (OR=0.73, 95% CI=0.49-0.80) were associated with more frequent fecal incontinence.


CONCLUSIONS
In community-dwelling older adults, fecal incontinence is a common condition associated with chronic diarrhea, multiple health problems, and poor self-perceived health. Fecal incontinence should be included in the review of systems for older patients.
Goode
Patricia S
PS
Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, 700 19th Street S., Birmingham, AL 35233, USA. pgoode@uab.edu
Burgio
Kathryn L
KL
Halli
Anne D
AD
Jones
Rebecca W
RW
Richter
Holly E
HE
Redden
David T
DT
Baker
Patricia S
PS
Allman
Richard M
RM
D001741:Black or African American / Q000706:statistics & numerical data; D000368:Aged; D000369:Aged, 80 and over; D000407:Alabama / Q000453:epidemiology; D000704:Analysis of Variance; D002908:Chronic Disease; D003430:Cross-Sectional Studies; D003967:Diarrhea / Q000453:epidemiology; D005242:Fecal Incontinence / Q000453:epidemiology*; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D015999:Multivariate Analysis; D015995:Prevalence; D012307:Risk Factors; D017678:Sex Distribution; D044465:White People / Q000706:statistics & numerical data