Abstract
BACKGROUND: The prevalence and impact of urinary incontinence has been investigated much less in older men than in older women. It is suggested that those who perceive that their daily lives are affected should have priority for services. However, many people do not seek medical help, even though they may be severely affected. AIM: To investigate unmet need in relation to the prevalence and impact on everyday life of urinary incontinence in men and women over the age of 65 years. DESIGN OF STUDY: Cross-sectional survey to measure prevalence of urinary incontinence, the impact on people's lives, use of protection, and health services. SETTING: Stratified random sample of 2000 community-living elderly (equal numbers of men and women, aged 65 to 74 years and over 75 years) in 11 general practices in a British city. RESULTS: The response rate was 79%. The overall prevalence of incontinence in the previous month was 31% for women and 23% for men. Women generally had more severe frequency of incontinence and a greater degree of wetness than men. Protection use was greater in women than in men. Only 40% of men and 45% of women with incontinence had accessed health services. Significant predictors of the use of health services were: incontinence reported as a problem, increased frequency of incontinence, and greater degree of wetness. About one-third of people who leaked with severe frequency or who reported that it was a problem had not accessed NHS services for incontinence. CONCLUSIONS: Urinary incontinence is a common problem for older men and women living in the community and can have a deleterious effect on their lives. There is the opportunity to improve the lives of many older people with urinary incontinence, probably by a combination of increased public, patient, and professional awareness that should lead to earlier presentation and initiation of effective care.
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Selected References
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- Bogren M. A., Hvarfwén E., Fridlund B. Urinary incontinence among a 65-year old Swedish population: medical history and psychosocial consequences. Vard Nord Utveckl Forsk. 1997;17(3):21–24. doi: 10.1177/010740839701700304. [DOI] [PubMed] [Google Scholar]
- Branch L. G., Walker L. A., Wetle T. T., DuBeau C. E., Resnick N. M. Urinary incontinence knowledge among community-dwelling people 65 years of age and older. J Am Geriatr Soc. 1994 Dec;42(12):1257–1262. doi: 10.1111/j.1532-5415.1994.tb06507.x. [DOI] [PubMed] [Google Scholar]
- Brocklehurst J. C. Urinary incontinence in the community--analysis of a MORI poll. BMJ. 1993 Mar 27;306(6881):832–834. doi: 10.1136/bmj.306.6881.832. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Brown J. S., Subak L. L., Gras J., Brown B. A., Kuppermann M., Posner S. F. Urge incontinence: the patient's perspective. J Womens Health. 1998 Dec;7(10):1263–1269. doi: 10.1089/jwh.1998.7.1263. [DOI] [PubMed] [Google Scholar]
- Cohen S. J., Robinson D., Dugan E., Howard G., Suggs P. K., Pearce K. F., Carroll D. D., McGann P., Preisser J. Communication between older adults and their physicians about urinary incontinence. J Gerontol A Biol Sci Med Sci. 1999 Jan;54(1):M34–M37. doi: 10.1093/gerona/54.1.m34. [DOI] [PubMed] [Google Scholar]
- Feneley R. C., Shepherd A. M., Powell P. H., Blannin J. Urinary incontinence: prevalence and needs. Br J Urol. 1979 Dec;51(6):493–496. doi: 10.1111/j.1464-410x.1979.tb03585.x. [DOI] [PubMed] [Google Scholar]
- Hunskaar S. Fluctuations in lower urinary tract symptoms in women. Reassurance and watchful waiting can prevent overtreatment. BMJ. 2000 May 27;320(7247):1418–1419. doi: 10.1136/bmj.320.7247.1418. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Mitteness L. S. Knowledge and beliefs about urinary incontinence in adulthood and old age. J Am Geriatr Soc. 1990 Mar;38(3):374–378. doi: 10.1111/j.1532-5415.1990.tb03525.x. [DOI] [PubMed] [Google Scholar]
- Norton C. The effects of urinary incontinence in women. Int Rehabil Med. 1982;4(1):9–14. doi: 10.3109/03790798209166812. [DOI] [PubMed] [Google Scholar]
- O'Brien J., Austin M., Sethi P., O'Boyle P. Urinary incontinence: prevalence, need for treatment, and effectiveness of intervention by nurse. BMJ. 1991 Nov 23;303(6813):1308–1312. doi: 10.1136/bmj.303.6813.1308. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Perry S., Shaw C., Assassa P., Dallosso H., Williams K., Brittain K. R., Mensah F., Smith N., Clarke M., Jagger C. An epidemiological study to establish the prevalence of urinary symptoms and felt need in the community: the Leicestershire MRC Incontinence Study. Leicestershire MRC Incontinence Study Team. J Public Health Med. 2000 Sep;22(3):427–434. doi: 10.1093/pubmed/22.3.427. [DOI] [PubMed] [Google Scholar]
- Roberts R. O., Jacobsen S. J., Rhodes T., Reilly W. T., Girman C. J., Talley N. J., Lieber M. M. Urinary incontinence in a community-based cohort: prevalence and healthcare-seeking. J Am Geriatr Soc. 1998 Apr;46(4):467–472. doi: 10.1111/j.1532-5415.1998.tb02468.x. [DOI] [PubMed] [Google Scholar]
- Sandvik H., Hunskaar S., Seim A., Hermstad R., Vanvik A., Bratt H. Validation of a severity index in female urinary incontinence and its implementation in an epidemiological survey. J Epidemiol Community Health. 1993 Dec;47(6):497–499. doi: 10.1136/jech.47.6.497. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Seim A., Sivertsen B., Eriksen B. C., Hunskaar S. Treatment of urinary incontinence in women in general practice: observational study. BMJ. 1996 Jun 8;312(7044):1459–1462. doi: 10.1136/bmj.312.7044.1459. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Simeonova Z., Milsom I., Kullendorff A. M., Molander U., Bengtsson C. The prevalence of urinary incontinence and its influence on the quality of life in women from an urban Swedish population. Acta Obstet Gynecol Scand. 1999 Jul;78(6):546–551. [PubMed] [Google Scholar]
- Thomas T. M., Plymat K. R., Blannin J., Meade T. W. Prevalence of urinary incontinence. Br Med J. 1980 Nov 8;281(6250):1243–1245. doi: 10.1136/bmj.281.6250.1243. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Yarnell J. W., St Leger A. S. The prevalence, severity and factors associated with urinary incontinence in a random sample of the elderly. Age Ageing. 1979 May;8(2):81–85. doi: 10.1093/ageing/8.2.81. [DOI] [PubMed] [Google Scholar]