Medically recognized urinary incontinence and risks of hospitalization, nursing home admission and mortality

Objectives: this study examined the association between medically recognized urinary incontinence and risk of several disease conditions, hospitalization, nursing home admission and mortality. Design: review and abstraction of medical records and computerized data bases from 5986 members, aged 65 years and older, of a large health maintenance organization in northern California. Results: there was an increased risk of newly recognized urinary incontinence following a diagnosis of Parkinson's disease, dementia, stroke, depression and congestive heart failure in both men and women, after adjustment for age and cohort. The risk of hospitalization was 30% higher in women following the diagnosis of incontinence [relative risk (RR) = 1.3, 95% confidence interval (CI) = 1.2–1.5] and 50% higher in men (RR = 1.5, 95% CI = 1.3–1.6) after adjustment for age, cohort and co-morbid conditions. The adjusted risk of admission to a nursing facility was 2.0 times greater for incontinent women (95% CI = 1.7–2.4) and 3.2 times greater for incontinent men (95% CI = 2.7–3–8). In contrast, the adjusted risk of mortality was only slightly greater for women (RR= 1.1; 95% CI = 0.99–1.3) and men (RR= 1.2; 95% CI = 1.1–1.4). Conclusions: urinary incontinence increases the risk of hospitalization and substantially increases the risk of admission to a nursing home, independently of age, gender and the presence of other disease conditions, but has little effect on total mortality.