Communication between older adults and their physicians about urinary incontinence

Background. Urinary incontinence (UI) is a common but undertreated conditio n in older adults. The study objective was to determine older patients' cha racteristics related to communication patterns with their physicians about UI. Methods. Telephone surveys of a sample of patients age 60 and older who vis ited a primary care provider (PCP) for any reason within the past 2 months were conducted. Participating physicians included general internists and fa mily physicians from 41 primary care practices located in the 17 counties o f northwest North Carolina whose 435 incontinent and 711 continent patients completed the surveys. The main outcome measures were patients' frequency and amount of urinary leakage, being asked about incontinence, and initiati ng a discussion of incontinence if not asked by their PCP. Results. Age and gender were significant independent predictors of incontin ence. PCPs were significantly more likely to assess incontinent women than incontinent men (21% vs 10%, p = .053). The older cohorts of older adults w ere significantly more likely to be symptomatic for UI than their younger c ounterparts. However, the younger cohorts were more likely to be screened f or incontinence by their physicians. Conclusions. Despite the publication of guidelines on improving the screeni ng and management of UI, the problem remains common and underdetected in ol der adults. Physicians don't ask and patients don't tell. Interventions are needed to remind physicians to screen high risk patients and to encourage patients with UI to communicate with their physicians.