Correlates of urinary, fecal, and dual incontinence in older African-American and white men and women.
OBJECTIVE
To determine prevalence and correlates of urinary (UI), fecal (FI), and dual (DI) incontinence in community-dwelling older adults.


METHODS
Cross-sectional, population-based in-home survey.


METHODS
Three rural and two urban Alabama counties (1999-2001).


METHODS
Stratified random sample of 1,000 Medicare beneficiaries aged 65 and older: 25% African-American men, 25% white men, 25% African-American women, 25% white women.


METHODS
UI defined as involuntary urine loss at least monthly; FI defined as "In the past year, have you had any loss of control of your bowels, even a small amount that stained the underwear?" Independent variables were sociodemographics, medical history, and activities of daily living (ADLs) excluding toileting. Multinomial logistic regression models were constructed using UI, FI, and DI as dependent variables.


RESULTS
UI, FI, and DI prevalences were 27%, 6%, and 6%, respectively. White women had higher prevalence of UI (41.1% vs 24.6%, P<.001) and DI (18.5% vs 8.0%, P=.07) but not FI (4.4% vs 3.8%, P=.83) than African-American women. Men had no racial differences in prevalence (UI 22.2%, FI 7.7%, DI 4.6%). In women, UI, FI, and DI correlates included higher Charlson comorbidity score and depressive symptoms and greater ADL difficulty for UI and DI. In men, UI was associated with prostate disease and depressive symptoms; FI with chronic diarrhea, history of transient ischemic attack (TIA), and poor self-perceived health; and DI with history of TIA, foot and leg swelling, and depressive symptoms.


CONCLUSIONS
Women had racial differences as well as similar correlates of incontinence subtypes, whereas men did not.
Markland
Alayne D
AD
Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Birmingham, Alabama 35233, USA. markland@uab.edu
Goode
Patricia S
PS
Burgio
Kathryn L
KL
Redden
David T
DT
Richter
Holly E
HE
Sawyer
Patricia
P
Allman
Richard M
RM
D000203:Activities of Daily Living; D001741:Black or African American / Q000706:statistics & numerical data*; D000368:Aged; D000369:Aged, 80 and over; D000407:Alabama / Q000453:epidemiology; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005242:Fecal Incontinence / Q000453:epidemiology / Q000208:ethnology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D016015:Logistic Models; D008297:Male; D006278:Medicare; D015995:Prevalence; D012307:Risk Factors; D012737:Sex Factors; D011795:Surveys and Questionnaires; D014481:United States; D014549:Urinary Incontinence / Q000453:epidemiology / Q000208:ethnology*; D044465:White People / Q000706:statistics & numerical data*