The prevalence of incontinence in people with cognitive impairment or dementia living at home: A systematic review

Abstract

AimsTo investigate the prevalence of urinary and faecal incontinence in people with cognitive impairment or dementia, living at home MethodWe searched electronic databases, MEDLINE , EMBASE, CINAHL, PsycINFO, BNI, and the Cochrane Library (including DARE, NTIS), were searched from 1st January 1990 to 1stSeptember 2008 and then searches were updated to 2012 week 13 (4 th April) for studies reporting prevalence data of urinary and faecal incontinence in the population of interest.Quality assessments of studies considered risk of bias in criteria for prevalence studies. Due to the heterogeneity of the included study populations and results, meta-analysis was not appropriate and a narrative analysis was undertaken. ResultsFrom 427 references, eight studies met the inclusion criteria. Seven studies provided prevalence rates as findings incidental to their primary question. Populations and assessment tools were varied. Reported prevalence of urinary incontinence ranged from 1.1% in a general community population to 38% in those receiving home care services. Reported rates of faecal incontinence were from 0.9% in a community population to 27% in a population attending an old age psychiatry outpatient clinic. ConclusionsThe prevalence of incontinence in people with dementia or cognitive impairment living at home has not been clearly established. Population level data is required to inform clinicians and to reliably underpin decision-making in service planning, resource allocation and interventions for people with dementia and incontinence.

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

“…The high prevalence of incontinence in people with dementia who reside in care homes is well documented [8], but international estimates suggest that over two-thirds of all people with dementia live in their own homes [20],[21]. Effective planning and commissioning of services for this population requires data on the incidence of incontinence among people with dementia living at home, yet a recent systematic review identified that there were no published studies that reported the incidence or prevalence of urinary and/or faecal incontinence in this community-dwelling population [22]. One recent study in low- and middle-income countries (China, India, and Latin America) identified an increasing prevalence of incontinence with dementia severity [1].…”

Improving continence services for older people from the service-providers’ perspective: a qualitative interview study

“…Findings from an earlier epidemiological study to establish the prevalence of urinary symptoms in community-dwelling adults in Great Britain revealed that approximately 23% of women and 8.7% of men over the age of 40 years have urinary symptoms and that the prevalence and severity of symptoms increase with age 2–4. For people with cognitive impairment or dementia, living at home results from a recent systematic review reported that the prevalence of UI ranged from 1.1% in a general community population to 38% in those receiving home care services 5. Direct costs of UI to the National Health Service (NHS) are reported to be greater than those associated with chronic common illnesses, such as coronary care and cancer care, with these costs expected to rise due to the increase in the ageing population 6.…”

Changing practice in dementia care in the community: developing and testing evidence-based interventions, from timely diagnosis to end of life (EVIDEM)

“…52 Assessment of risk of bias found that all studies had some aspect that was judged to be a risk; this has been reported in full elsewhere. 137 The reported prevalence rates are presented in Table 36. The prevalence of UI ranged from 1.1% in a general community population to 38% in those receiving home care services.…”