Prevalence correlates and impact of fecal incontinence among older women.
BACKGROUND
Fecal incontinence is a common problem that has been associated with anatomic, physiological, and medical conditions. There are very few data on the factors associated with fecal incontinence in elderly women.


OBJECTIVE
We aimed to determine the factors associated with fecal incontinence via a population-based survey in a large cohort of elderly Australian women.


METHODS
Data from a large longitudinal population-based study of elderly Australian women aged 82 to 87 years were analyzed.


METHODS
Participants were 5560 women (aged 82-87 years) who participated in the Australian Longitudinal Study on Women's Health; 4815 women responded to questions relating to fecal incontinence.


METHODS
Fecal incontinence was defined as leakage of liquid and/or solid stool at least once per month over the past 12 months. Self-reported medical conditions and lifestyle factors as well as demographic factors were recorded.


RESULTS
The prevalence of fecal incontinence was 10.4% (95% CI, 9.6-11.3) (n = 510). The prevalence was significantly higher among institutional- versus community-dwelling women (14.1% vs 9.7%; p = 0.0002). Univariately, lifestyle factors including fruit intake and fluid intake, along with a range of comorbidities, were associated. However, independent factors for fecal incontinence among community-dwelling women included diabetes mellitus (OR, 1.51; 95% CI, 1.14-2.01; p = 0.004), depression (OR, 1.84; 95% CI, 1.30-2.62; p = 0.001), urinary incontinence (OR, 2.29; 95% CI, 1.83-2.86; p < 0.0001), and osteoarthritis (OR, 0.73; 95% CI, 0.57-0.94; p = 0.013). Among institutional-dwelling women, however, we found urinary incontinence (OR, 4.43; 95% CI, 2.83-6.93; p < 0.0001) and poorer general health (OR, 0.98; 95% CI, 0.97-0.99; p = 0.003) to be independently associated.


CONCLUSIONS
This is a cross-sectional study, which prevents making conclusions about the cause and effect of observed correlations.


CONCLUSIONS
The independent factors associated with fecal incontinence in this population do not appear readily modifiable, and many previously identified risk factors may not be important in the elderly women with fecal incontinence.
Department of Gastroenterology, John Hunter Hospital, Newcastle, New South Wales, Australia.
Magnus
M
Halland
Natasha A
NA
Koloski
Michael
M
Jones
Julie
J
Byles
Pauline
P
Chiarelli
Peta
P
Forder
Nicholas J
NJ
Talley
D000369:Aged, 80 and over; D001315:Australia / Q000453:epidemiology; D015897:Comorbidity; D017281:Cost of Illness; D003430:Cross-Sectional Studies; D005242:Fecal Incontinence / Q000453:epidemiology / Q000209:etiology* / Q000523:psychology; D005260:Female; D006306:Health Surveys; D006801:Humans; D008019:Life Style; D015999:Multivariate Analysis; D015995:Prevalence; D011788:Quality of Life; D012307:Risk Factors; D057566:Self Report; D012959:Socioeconomic Factors