Predictors of urinary and faecal incontinence in pre-frail and frail older adults: a cross-sectional study of the FRAGSALUD project

Juan Corral-Pérez; Laura Ávila-Cabeza-de-Vaca; Inmaculada Valero-Cantero; Andrea González-Mariscal; Jesús G Ponce-González; María Ángeles Vázquez-Sánchez; Cristina Casals

doi:10.1093/gerona/glae072

Predictors of urinary and faecal incontinence in pre-frail and frail older adults: a cross-sectional study of the FRAGSALUD project

J Gerontol A Biol Sci Med Sci. 2024 Mar 4:glae072. doi: 10.1093/gerona/glae072. Online ahead of print.

Authors

Juan Corral-Pérez¹, Laura Ávila-Cabeza-de-Vaca¹, Inmaculada Valero-Cantero², Andrea González-Mariscal¹, Jesús G Ponce-González¹, María Ángeles Vázquez-Sánchez³, Cristina Casals¹

Affiliations

¹ ExPhy Research Group, Department of Physical Education, Instituto de Investigación e Innovación Biomédica de Cádiz (INiBICA), Universidad de Cádiz, Cádiz, Spain.
² Puerta Blanca Clinical Management Unit, Malaga-Guadalhorce Health District, Málaga, Spain.
³ Department of Nursing, Faculty of Health Sciences, PASOS Research Group, University of Málaga, Málaga, Spain.

PMID: 38436435
DOI: 10.1093/gerona/glae072

Abstract

Background: Frailty is associated with urinary and faecal incontinence, which are common geriatric syndromes. This study aims to identify health factors associated with incontinence in pre-frail or frail older adults living in the community.

Methods: This multicentre cross-sectional study included 225 older adults (75.0±6.4 years) with pre-frailty or frailty based on the five-component Fried phenotype. Physical function was assessed using the Short Physical Performance Battery (SPPB). Physical activity, inactivity, and sleep were estimated using a wrist-worn accelerometer. Urinary or faecal incontinence was registered using the Barthel scale (urine and bowel items). Multivariable logistic regression analyses, with age as a covariate, were conducted to identify associations of incontinence.

Results: In our participants, 27% presented urinary or faecal incontinence with no sex differences (P=0.266). Our results showed that age, daily medication count, and number of falls in the previous year independently predicted incontinence in frail and pre-frail older adults (P<0.05). Some Fried's criteria, including self-reported exhaustion, gait speed, and handgrip strength were associated with the presence of incontinence (P<0.05), but not Fried's classification. The SPPB total score and its isolated variables were significantly associated with the urinary and faecal incontinence (P<0.05). However, none of the accelerometer outcomes showed significant associations with incontinence status.

Conclusions: According to this study, age, number of medications, and falls (but not sex) are linked to urinary and faecal incontinence in frail or pre-frail older adults living in the community, recommending the assessment of physical function using the SPPB rather than estimating daily physical activity, inactivity, or sleep.

Keywords: Fecal incontinence; Frailty; Physical activity; Physical function; Urinary incontinence.