title: Urinary incontinence, but not fecal incontinence, is a risk factor for admission to aged residential care of older persons in New Zealand.
abstract: OBJECTIVE
  To determine if urinary incontinence (UI) and fecal incontinence (FI) were independent risk factors for aged resident care (ARC) admissions for older people, after controlling for confounders and applying apposite statistical methods.
  
  
  METHODS
  Since 2012, all community care recipients in New Zealand have undergone a standardized needs assessment using the Home Care International Residential Assessment Instrument (interRAI-HC). The interRAI-HC instrument elicits information on 236 questions over 20 domains, including UI and FI frequency within the last 3 days. Those aged 65+ years with an interRAI-HC assessment between July 1, 2012 and May 31, 2014 were matched to national mortality and ARC databases, and competing-risk regression models applied to those without collection devices or indwelling catheters who were admitted to ARC or alive 30+ days after their interRAI-HC assessment.
  
  
  RESULTS
  Overall, 32 285 people were eligible, with average age of 82.1 years (range 65, 105 years) of whom 20 627 (63.9%) were female. UI and FI was reported by 36.4% and 12.9% of people, respectively. By June 30, 2014, 5993 (18.6%) had an ARC admission and 5443 (16.9%) had died before any such admission. In the multivariable analysis, the subhazard ratio (SHR) for ARC admission was significant for UI (SHR = 1.11, 95%CI: 1.05, 1.18) but not for FI (SHR = 1.07, 95%CI: 0.99, 1.16).
  
  
  CONCLUSIONS
  UI is a common, independent risk factor for ARC admissions. Identifying the extent of incontinence and its impact on ARC admissions is the first vital step in addressing the burgeoning need for better community continence services.
authors: School of Health Sciences, University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, New Zealand.|School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia.
authors: Philip J
authors: PJ
authors: Schluter
authors: School of Health Sciences, University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, New Zealand.
authors: Charlotte
authors: C
authors: Ward
authors: University of Otago, Christchurch, New Zealand.
authors: Edwin P
authors: EP
authors: Arnold
authors: Canterbury District Health Board, Older Person's Health, Christchurch, New Zealand.
authors: Richard
authors: R
authors: Scrase
authors: University of Otago, Christchurch, New Zealand.|Canterbury District Health Board, Older Person's Health, Christchurch, New Zealand.
authors: Hamish A
authors: HA
authors: Jamieson
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D016208:Databases, Factual; D005242:Fecal Incontinence / Q000175:diagnosis*; D005260:Female; D006707:Homes for the Aged; D006760:Hospitalization; D006801:Humans; D008297:Male; D020380:Needs Assessment; D009520:New Zealand; D009735:Nursing Homes; D012307:Risk Factors; D014549:Urinary Incontinence / Q000175:diagnosis*
keywords: community care assessment; epidemiology; incontinence; interRAI instrument; population health