Study: Dementia Patients Have Higher Risk of Experiencing Incontinence

Dementia patients are three times more likely to experience urinary incontinence, and four times more likely to have fecal incontinence, according to a new study found in PLOS Medicine.

British researchers from Kingston University, St. George’s University of London, and University College of London pulled data collected between 2001 and 2010 on incontinence from The Health Improvement Network (THIN) primary care database in the UK. Their sample size included 54,816 dementia patients aged 60-89 years and an age-gender stratified sample of 205,795 non-dementia patients.

Men with dementia were more than twice as likely to have urinary incontinence (42.3 per 1,000) than men without dementia (19.8 per 1,000). Rates of urinary incontinence for women were 33.5 per 1,000 dementia patients versus 18.6 per 1,000 non-dementia patients.

Regarding fecal incontinence, rates of first diagnosis were 11.1 and 10.1 in the dementia cohort, and 3.1 and 3.6 in the non-dementia cohort among men and women, respectively.

Those with dementia were also more likely to use indwelling urinary catheters, which increase the risk of infection.

The researchers concluded that policymakers, insurers, and health care practitioners caring for people with dementia should be aware of incontinence issues and how to properly manage them.

“Incontinence in people with dementia is distressing for the person with dementia and for their carers and often influences decisions to move individuals into care homes. However, little is known about the diagnosis and treatment of urinary and/or fecal incontinence among people with dementia living at home. This information is needed to help policymakers commission the services required for this section of society and insurers recognize the needs such patients have, as well as helping to raise clinicians’ awareness of the issue,” the researchers said.

Source: Grant RL, Drennan VM, Rait G, Petersen I, Iliffe S (2013) First Diagnosis and Management of Incontinence in Older People with and without Dementia in Primary Care: A Cohort Study Using The Health Improvement Network Primary Care Database. PLoS Med 10(8): e1001505. doi:10.1371/journal.pmed.1001505