Dual Incontinence and Risk of Fall: A Retrospective Cohort Study

Abstract

Importance Although there is a known association between urinary incontinence (UI) and fall risk, it is unclear if having both UI and fecal incontinence, or dual incontinence (DI), increases this risk. Objective The objective of our study was to elucidate a relationship between DI and falls. Study Design This was a retrospective cohort study at a tertiary academic health system of female patients 65 years and older presenting for a new patient visit to a urogynecology health care professional for UI from 2019 to 2021. Demographic data and responses to intake questionnaires on fall and markers of frailty were extracted. Multivariable logistic regression was performed to identify factors associated with fall adjusting for covariates identified upon univariate comparison. Results A total of 2,814 women were included in the analysis; 2,661 patients reported UI alone, and 153 reported DI. A greater proportion of women with DI reported a fall in the past year compared with those with UI alone (22.9% vs 12.2%, P < 0.001). Univariable comparison showed that these 2 groups differed regarding age, body mass index, and estimated median household income. On multivariable logistic regression, DI was significantly associated with falls (adjusted odds ratio 2.56; 95% confidence interval, 1.02–5.46). Other factors independently associated with falls in older women with UI include (adjusted odds ratio, 95% confidence interval): lower income groups (2.35, 1.50–3.67 for $20,000–$40,000, compared with $100,000 and higher-income group), difficulty with activities of daily living (1.60, 1.25–2.13), and unintentional weight loss (1.68, 1.05–2.68). Conclusion Patients with DI have a 2-fold higher risk of fall compared with patients with UI alone.