Wu Jennifer M, Matthews Catherine A, Vaughan Camille P, Markland Alayne D
Division of Urogynecology and Reconstructive Pelvic Surgery, Department of Obstetrics and Gynecology, University of North Carolina, Chapel Hill, North Carolina.
Center of Aging and Health, University of North Carolina, Chapel Hill, North Carolina.
J Am Geriatr Soc. 2015 May;63(5):947-53. doi: 10.1111/jgs.13385. Epub 2015 May 4.
To estimate the prevalence of urinary (UI), fecal (FI), and dual incontinence (DI) and to identify shared factors associated with each type of incontinence in older U.S. women and men.
Population-based cross-sectional study.
National Health and Nutrition Examination Survey (NHANES, 2005-2010).
Women and men aged 50 and older.
UI was defined as moderate to severe (≥3 on a validated UI severity index, range 0-12); FI was at least monthly loss of solid, liquid, or mucus stool; and DI was the presence of UI and FI.
Women were more likely than men to report UI only and DI but not FI only (UI only, women 19.8%, men 6.4%; FI only, women 8.2%, men 8.4%; DI women, 6.0%, men 1.9%). In both sexes, prevalence increased with age. In regression models adjusted for parity and hysterectomy, DI in women was associated with non-Hispanic white race (odds ratio (OR)=2.3, 95% confidence interval (CI)=1.5-3.4), depression (OR=4.7, 95% CI=2.0-11.1), comorbidities (OR=4.3, 95% CI=1.9-9.6 for ≥3 comorbidities vs none), hysterectomy (OR=1.8, 95% CI=1.2-2.7), and diarrhea (OR=2.8, 95% CI=1.5-5.0). In men, ADL impairment (OR=2.4, 95% CI=1.2-4.9) and poorer self-rated health (OR=2.8, 95% CI=1.5-5.30) were associated with DI.
UI, FI, and DI are common in older women and men. Factors associated with DI were distinct from those associated with UI and FI. There were also differences according to sex, with DI associated with depression and comorbid diseases in women and lack of functional ability and poorer self-rated health in men.
评估尿失禁（UI）、粪失禁（FI）和混合性失禁（DI）的患病率，并确定美国老年女性和男性中与每种类型失禁相关的共同因素。
基于人群的横断面研究。
国家健康与营养检查调查（NHANES，2005 - 2010年）。
年龄在50岁及以上的女性和男性。
UI定义为中度至重度（在经过验证的UI严重程度指数上≥3，范围为0 - 12）；FI定义为至少每月有一次固体、液体或黏液便失禁；DI定义为同时存在UI和FI。
女性比男性更有可能仅报告UI和DI，但不是仅报告FI（仅UI，女性为19.8%，男性为6.4%；仅FI，女性为8.2%，男性为8.4%；DI，女性为6.0%，男性为1.9%）。在两性中，患病率均随年龄增长而增加。在根据产次和子宫切除术进行调整的回归模型中，女性的DI与非西班牙裔白人种族（优势比（OR）=2.3，95%置信区间（CI）=1.5 - 3.4）、抑郁症（OR = 4.7，95% CI = 2.0 - 11.1）、合并症（≥3种合并症与无合并症相比，OR = 4.3，95% CI = 1.9 - 9.6）、子宫切除术（OR = 1.8，95% CI = 1.2 - 2.7）以及腹泻（OR = 2.8，95% CI = 1.5 - 5.0）相关。在男性中，日常生活活动能力受损（OR = 2.4，95% CI = 1.2 - 4.9）和自我健康评价较差（OR = 2.8，95% CI = 1.5 - 5.30）与DI相关。
UI、FI和DI在老年女性和男性中很常见。与DI相关的因素与与UI和FI相关的因素不同。根据性别也存在差异，女性的DI与抑郁症和合并疾病相关，而男性的DI与功能能力缺乏和自我健康评价较差相关。
