Self-care practices used by older men and women to manage urinary incontinence: Results from the national follow-up survey on self-care and aging

OBJECTIVES: To estimate the extent to which self-care practices are employe d by older adults with urinary incontinence (UI); to determine how demograp hic and functional status measures are associated with self-care practice u se; and to explore the relationship between contacting a doctor and disposa ble pad use. DESIGN: A cross-sectional analysis of a national probability sample using m ultiple logistic regression. SETTING: Responses of subjects with UI (n = 787) from the 1993-1994 Nationa l Follow-up Survey on Self-Care and Aging, a follow-up survey of older Medi care beneficiaries living in the community within the contiguous United Sta tes drawn in 1990-1991 MEASURES: Subject responses about UI, fecal incontinence, dressing, eating, bathing, Instrumental Activities of Daily Living (IADL), Mobility Activiti es of Daily Living (MADL), age, gender, place of residence, race, education , proxy response to the survey, and self-reported medical conditions. RESULTS: Self-care practices used by more than 25% of respondents with UI i ncluded using disposable pads, limiting trips, and limiting fluids. Among o lder adults with incontinence, more women used disposable pads (44.5%; 95% CI, 36.9-52.1) and performed exercises (14.2%; 95% CI, 9.7-18.9) than did m en (15.1%; 95% CI, 8.1-22.1; and 4.3%; 95% CI, 1.0-7.7, respectively). Bi-v ariate analysis showed respondents with severe UI or fecal incontinence rep orted greater use of self-care practices. In multivariate models of the thr ee most commonly used self-care practices, measures of UT severity were not always associated independently with self-care practice use, whereas ADL m easures of functional status were. Disposable pad use was positively indepe ndently associated (OR 3.36; 95% CI, 2.01-5.63) in multivariate models with contacting a doctor about incontinence, even after controlling for age, ge nder, demographics, and self-reported medical conditions. CONCLUSIONS: Use by older adults of self-care practices to manage urinary i ncontinence is predicted independently in multivariate models by measures o f functional status such as dressing, eating, bathing, IADLs or MADLs, but not by all UI measures. Disposable pad users had increased odds of contacti ng a doctor, suggesting that self-care practices and formal medical care ar e not always inversely related.