URINARY-INCONTINENCE IN ELDERLY INPATIENTS IN JAPAN - A COMPARISON BETWEEN GENERAL AND GERIATRIC HOSPITALS

This is the first multi-hospital epidemiological study to elucidate th e prevalence and characteristics of urinary incontinence in elderly in patients throughout Japan. Of the 2586 subjects to whom questionnaire s were issued, 1563 (60.4%) (65 to 102 years old, 598 men, 965 women) were suitable for the study. A total of 817 patients were hospitalized in geriatric hospitals; that is, geriatric facilities under the regul ation of the Department of Health and Welfare. All patients were evalu ated by medical doctors for the following items: age, sex, duration of hospitalization, activities of daily living, medical diagnosis, prese nce or absence of urinary incontinence, type of urinary incontinence, and therapy for urinary incontinence. The prevalence of urinary incont inence in patients under 70, 70-79, 80-89, and over 90 years old was 5 9.3%, 67.7%, 79.8%, and 82.2%, respectively. Overall, 1142 patients (7 2.0%) suffered from urinary incontinence. Cerebrovascular disease was the major cause of admission to hospital in patients with urinary inco ntinence (37.0%). The most frequent type of urinary incontinence was f unctional urinary incontinence in patients who were mentally and/or ph ysically unable to go to the bathroom without aid (21.5%). Specificall y, 38.1% of patients in geriatric hospitals were diagnosed as having f unctional urinary incontinence, in contrast to only 3.9% of patients i n non-geriatric units. In patients with dementia, 88.7% were incontine nt, whereas in patients without dementia, the prevalence of urinary in continence was much lower (51.5%, p<0.001). Another predisposing facto r for urinary incontinence was urinary tract infection. The prevalence of urinary incontinence in patients with and without urinary tract in fection was 87.8% and 59.5%, respectively (p<0.001). Almost all patien ts with poor activities of daily living (who were bedridden) suffered from urinary incontinence (98.5%). On the other hand, urinary incontin ence was not so frequent in patients who could walk (26.9%). Pad (42.8 %) and indwelling bladder catheter (18.3%) were the major means of man agement of incontinence, whereas behavioral therapy (4.9%) and surgery (0.5%) were nor common. These results suggest that elderly patients w ith treatable urinary incontinence do not receive adequate therapy in Japan.