March 30, 2006

Women in nursing homes often have bladder problems

By Clementine Wallace

NEW YORK (Reuters Health) - While a very small proportion
of female nursing home residents are diagnosed with urinary
incontinence, more than half actually have problems with
bladder control, researchers report.

Incontinence -- defined in this context not only by leakage
of urine but also by the need for assistance in using the
toilet -- can lead to medical complications such as bed sores
and urinary tract infections, according to Dr. Jennifer Anger,
from the University of California in Los Angeles.

Residents' medical records indicate that the prevalence of
incontinence among women in US nursing homes is only 1 to 2
percent, Anger and colleagues report in the medical journal

"However, when you then ask caregivers or patients if they
have difficulty controlling their urination, or if they needed
assistance in using the toilet, you realize that proportions
are extremely different," Anger told Reuters Health.

"It shows that very few doctors focus on incontinence or
even address the issue, and there needs to be better inquiry to
patients," she added.

To compare administrative versus clinical estimates of the
prevalence of incontinence, Anger's team examined data from the
1999 National Nursing Home Survey, which collected information
from 1500 facilities.

The analysis showed that less than 1.4 percent of female
nursing home residents had been diagnosed with urinary
incontinence. On the other hand, 58.6 percent of all the women
were reported to have difficulty controlling urination, and
more than one half needed assistance in using the toilet.

"This shows that the prevalence is much higher than their
medical records show, and it highlights the limitations of
using administrative data to study the epidemiology of bladder
dysfunction," Anger noted.

SOURCE: Urology, February 2006.