Prevalence of urinary incontinence and its associated factors among older adults living in nursing homes in Catalonia (Spain)

Jerez-Roig J1, Moreno-Martin P1, Torrents-Solé M2, Solé-Casals M3, Carbó-Cardeña A1, Serra-Llandrich A2, Casacuberta-Roca J1, Coll-Planas L1

Research Type

Pure and Applied Science / Translational

Abstract Category

Geriatrics / Gerontology

Abstract 688
Open Discussion ePosters
Scientific Open Discussion Session 106
Thursday 24th October 2024
16:55 - 17:00 (ePoster Station 4)
Exhibition Hall
Incontinence Gerontology Outcomes Research Methods
1. Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia (UVic-UCC). Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain., 2. Faculty of Health Sciences and Welfare. University of Vic-Central University of Catalonia (UVic-UCC), Vic, Spain., 3. Central Catalonia Chronicity Research Group (C3RG). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS). University of Vic-Central University of Catalonia (UVic-UCC).
Presenter
Links

Poster

Abstract

Hypothesis / aims of study
There are currently around 59,000 individuals living in long term-care institutions in Catalonia (Spain), with approximately 912 registered facilities. However, there is no published comprehensive information on the continence status of these residents. Therefore, the main objective of this study was to estimate the prevalence of urinary incontinence (UI) and analyze its associated factors among older adults living in nursing homes (NHs) in Catalonia. As secondary objective, we also aimed at estimating the prevalence of fecal incontinence (FI) and double (urinary and fecal) incontinence.
Study design, materials and methods
This is a cross-sectional study conducted in the region of Catalonia. Data collection was carried out from December 2021 to June 2022. Among the 779 NHs registered in Catalonia, 30 were randomly selected according to size (small <50 residents, medium 50-100 residents, and large >100) and type of governance (public, private, and mixed funding); 25% of residents living in medium and large NHs were randomly selected, while all residents in small NHs were recruited for participation. If a selected resident declined participation, the next resident randomized on the waiting list was included in the sample.  
A multidimensional assessment was carried out, considering sociodemographic information (gender, age, duration of institutionalization, educational level, and marital status), Covid-related variables, morbidity, medications, symptoms (pain and dyspnea), falls, dysphagia, delirium, constipation, sensory deficits (sight and hearing), basic activities of daily living (modified Barthel Index), instrumental activities of daily living (ability to manage money, phone, and handling medication), cognitive capacity (Global Deterioration Scale), emotional status, loneliness, social network, the meaning of life, impact of Covid on health and quality of life, and frailty assessed with the modified Frail-VIG index (1). The Minimum Data Set was used to assess UI and FI. A pilot study was carried out in one NH to test the feasibility of the procedures and adjust the instruments. Data were collected through proxy respondents (NH staff) by trained researchers.
For the estimation of the prevalence of UI, FI and double incontinence, 95% confidence intervals (CI) were calculated. In bivariate analysis, the chi-square test was applied for categorical variables. Quantitative variables did not follow normal distribution, so the Mann-Whitney test was used. Multivariate analysis was carried out with logistic regression. Odds ratio (OR) was used as measure of association.
Results
The final sample consisted of 669 residents, primarily female (75.0%), with an average age of 85.9 (standard deviation-SD=8.8) years and institutionalization duration averaging 36.6 months (SD=77.0). 
The prevalence of UI, FI and double incontinence was 73.6% (95% CI: 70.1-76.8), 47.5% (95% CI: 43.8-51.3) and 46.7% (95% CI: 42.9-50.5), respectively. 
In the multivariate analysis, UI was significantly associated with women (p=0.028), mobility limitations (p<0.001), cognitive impairment (p<0.001), dysphagia (p=0.016), renal disease (p=0.038), access to nature (p<0.001), constipation (p<0.001), ratio shared/total rooms (p=0.024), independently of age.
Interpretation of results
•	UI was associated with the individual factors ‘women, mobility limitations, cognitive impairment, dysphagia, constipation and renal disease’ as well as environmental factors ‘access to nature and ratio shared/total rooms’, independently of age.  
•	Almost 3 out of 4 NH residents in Catalonia suffer from UI.
•	Approximately 1 out of 2 NH residents in Catalonia have FI. 
•	Approximately 1 out of 2 NH residents in Catalonia suffer from a combination of urinary and fecal losses.
Concluding message
Continence problems are highly common in NH residents in Catalonia, with approximately 74% prevalence of UI and 47-48% prevalence of FI and double incontinence. UI was associated with women, mobility limitations, cognitive impairment, dysphagia, constipation, renal disease, access to nature and ratio shared/total rooms.
Figure 1 Table 1. Factors associated with UI among NH residents in Catalonia, Spain (n=669).
References
  1. Amblàs-Novellas J, Martori JC, Joan Espaulella, Oller R, Molist-Brunet N, Inzitari M and Romero-Ortuno R. Frail-VIG index: a concise frailty evaluation tool for rapid geriatric assessment. BMC Geriatrics (2018), 18:29 DOI: 10.1186/s12877-018-0718-2
Disclosures
Funding Agency for Management of University, and Research Grants from the University and Research Department of Catalan Government (2020PANDE00184) Clinical Trial No Subjects Human Ethics Committee Ethics and Research Committee of the University of Vic - Central University of Catalonia (UVic-UCC) and the Ethics Committee of Universitat Oberta de Catalunya (UOC) Helsinki Yes Informed Consent Yes
19/04/2025 21:51:41