Unreported urinary incontinence: population-based prevalence and factors associated with non-reporting of symptoms in community-dwelling people ≥ 50 years

Key summary points

AbstractSection Aim

To ascertain the prevalence of unreported urinary incontinence (UI) in a large sample of older adults, to profile factors associated with under-reporting of UI and the association of unreported UI with self-rated quality of life.

AbstractSection Findings

Almost 40% of older people with UI had not reported their symptoms to a healthcare professional. On average those who did not report UI had visited their GP 4 times in the prior 12 months. Unreported UI was independently associated with poorer quality of life.

AbstractSection Message

This study highlights the importance of asking specifically about symptoms of UI as part of comprehensive assessment of the older adult in and emphasises the need for increased education and awareness for older people around the importance of seeking help and reporting UI.

Abstract

Purpose

Concerns exist around under-detection and under-treatment of urinary incontinence (UI) in specific patient groups, particularly older people. The aim of this study is to ascertain the prevalence of unreported UI in a large sample of older adults, to profile factors associated with under-reporting of UI and the association of unreported UI with quality of life (QOL).

Methods

This study was embedded within the Irish Longitudinal Study on Ageing, involving a population-representative sample of almost 7,000 older adults (55% female, mean age 65 years). UI was defined as involuntary loss of urine from the bladder occurring on average at least twice per month. Unreported UI had not yet been reported to a healthcare professional. QOL was measured using the Control, Autonomy, Self-realisation and Pleasure-19 Scale (CASP-19).

Results

Almost 40% (285/750) of participants with UI had not reported symptoms to a healthcare professional despite visiting their general practitioner (GP) on average over 4 times in the last year. Logistic regression modelling demonstrated that under-reporting of UI was associated with female sex, taking < 5 medications, less severe symptoms and lower number of GP visits. Linear regression models show that unreported UI was associated with significantly lower CASP-19 (β = − 1.20 (95% CI: − 2.19 to − 0.20)).

Conclusion

Only 40% of older people with UI report symptoms to a healthcare professional despite frequent symptoms, and a significant association with poorer QOL. This highlights the need to educate older people around seeking help for UI, as well as opportunistically addressing UI as part of comprehensive age-attuned care.

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Funding

Financial support was provided by Irish Government, the Atlantic Philanthropies and Irish Life plc. These funders were not involved in the study design, collection, analysis and interpretation of data, writing of the paper or submission for publication. Any views expressed in this report are not necessarily those of the Department of Health and Children or of the Minister for Health.

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Correspondence to Robert Briggs.

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The TILDA study was approved by the Faculty of Health Sciences research ethics committee at Trinity College Dublin.

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All participants gave informed written consent.

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Sullivan, R., McNicholas, T., Claffey, P. et al. Unreported urinary incontinence: population-based prevalence and factors associated with non-reporting of symptoms in community-dwelling people ≥ 50 years. Eur Geriatr Med 12, 405–412 (2021). https://doi.org/10.1007/s41999-020-00412-0

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Keywords

  • Urinary incontinence
  • Depression
  • Quality of life