Prevalence of urinary incontinence and associated risk factors in nursing home residents: A systematic review

Aims: To determine not only prevalence rates of urinary incontinence (UI) in nursing home residents but also factors influencing these prevalence rates, and to provide an overview of risk factors associated with UI in this group. Methods: A systematic review was performed using multiple databases including MEDLINE, EMBASE, CINAHL, PsycINFO and the Cochrane Library from January 1997 to April 2008. In addition, the bibliographies of all relevant articles were searched. Two authors independently assessed the eligibility of all studies and extracted data on study design, population characteristics, definition of incontinence, measurement instrument, risk factors and prevalence rates. Results: Twelve articles containing 16 studies met the eligibility criteria. Prevalence rates of UI in nursing home residents ranged from 43% to 77% (median 58%). When comparing studies, the influencing factors on UI prevalence of age and sex were identified. In total 45 risk factors were described. Within individual study populations, sex, age, cognitive function, dementia, bedfast and locomotion were associated with UI. Conclusions: UI prevalence rates in nursing homes are high and the influencing factors poorly understood. Although important risk factors similar to those in the general population have been identified, risk factors related to the care process should be further investigated. Neurourol. Urodynam. 28:288–294, 2009. 2009 Wiley-Liss, Inc.