Incidence and risk factors for fecal incontinence in black and white older adults: a population-based study.
OBJECTIVE
To determine the incidence of fecal incontinence (FI) in community-dwelling older adults and identify risk factors associated with incident FI.


METHODS
Planned secondary analysis of a longitudinal, population-based cohort study.


METHODS
Three rural and two urban Alabama counties (in-home assessments 2000-2005).


METHODS
Stratified random sample of 1,000 Medicare beneficiaries: 25% African-American men, 25% white men, 25% African-American women, 25% white women, aged 65 and older. Eligible participants for this analysis were continent at baseline and community-dwelling 4 years later (n=557).


METHODS
FI was defined as any loss of control of bowels occurring during the previous year. Independent variables were sociodemographics, Charlson comorbidity counts, self-reported bowel symptoms (chronic diarrhea and constipation), depression, and body mass index (BMI). Multivariable logistic regression models were constructed using incident FI as the dependent variable.


RESULTS
The incidence rate of FI at 4 years was 17% (95% confidence interval (CI)=13.7-20.1), with 6% developing FI at least monthly (95% CI=4.0-8.3). White women were more likely to have incident FI (22%) than African-American women (13%, P=.04); no racial differences were observed in men. Controlling for age, comorbidity count, and BMI, significant independent risk factors for incident FI in women were white race, depression, chronic diarrhea, and urinary incontinence (UI). UI was the only significant risk factor for incident FI in men.


CONCLUSIONS
The occurrence of new FI is common in men and women aged 65 and older, with a 17% incidence rate over 4 years. FI and UI may share common pathophysiologic mechanisms and need regular assessment in older adults.
Birmingham/Atlanta Geriatric Research, Education, and Clinical Center, Department of Veterans Affairs Medical Center, Birmingham, AL, USA. amarkland@aging.uab.edu
Alayne D
AD
Markland
Patricia S
PS
Goode
Kathryn L
KL
Burgio
David T
DT
Redden
Holly E
HE
Richter
Patricia
P
Sawyer
Richard M
RM
Allman
D001741:Black or African American / Q000706:statistics & numerical data*; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000407:Alabama; D015331:Cohort Studies; D005242:Fecal Incontinence / Q000150:complications / Q000208:ethnology* / Q000523:psychology; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D012307:Risk Factors; D012737:Sex Factors; D012959:Socioeconomic Factors; D014549:Urinary Incontinence / Q000150:complications / Q000453:epidemiology; D044465:White People / Q000706:statistics & numerical data*