True prevalence of urinary incontinence among female nursing home residents.
OBJECTIVE
Urinary incontinence is a significant problem in nursing home residents in the United States. Estimates of its prevalence have often been based on data from medical records obtained at nursing home admission. To measure the sensitivity of this method of defining the prevalence of urinary incontinence among female nursing home residents, we examined data from a clinical survey.


METHODS
We analyzed data from the National Nursing Home Survey, which collected information from nursing homes for each resident concerning admission diagnoses, presence of an indwelling Foley catheter or ostomy, need for assistance from equipment or personnel in using the toilet, and difficulty controlling urination.


RESULTS
Residents' medical records revealed a very low rate of admission diagnoses of incontinence. However, clinical queries revealed a high prevalence of bladder dysfunction. More than one half of all female nursing home residents were reported to have "difficulty controlling urination," and more than one half needed assistance in using the toilet.


CONCLUSIONS
Although only 1% to 2% of nursing home residents have a diagnosis of urinary incontinence, the true prevalence of bladder dysfunction in this group is much greater. The sharp divergence of National Nursing Home Survey data from published studies on the prevalence of incontinence in nursing homes highlights the limitations of using administrative data to study the epidemiology of bladder dysfunction.
Anger
Jennifer T
JT
Department of Urology, University of California, David Geffen School of Medicine, Los Angeles, California 90095-1738, USA. janger@mednet.ucla.edu
Saigal
Christopher S
CS
Pace
Jennifer
J
Rodríguez
Larissa V
LV
Litwin
Mark S
MS
D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D009735:Nursing Homes; D015995:Prevalence; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000453:epidemiology*