Self-reported urinary incontinence in noninstitutionalized long-term stroke survivors: A population-based study

Abstract

Objectives: To compare the prevalence of self-reported incontinence among noninstitutionalized long-term stroke survivors with population controls without stroke and to identify risk factors associated with urinary incontinence in the stroke survivors.

Design: Community-based, cross-sectional study.

Setting: Municipality of Tronso.

Participants: A total of 213 noninstitutionalized stroke survivors (mean time poststroke, 9y) and 242 control subjects.

Interventions: Not applicable.

Main outcome measure: Self-reported presence of urinary incontinence.

Results: Urinary incontinence was present in 17% of the stroke survivors and in 7% of the control subjects (odds ratio [OR]=2.8; 95% confidence interval [CI], 1.5-5.2) and more prevalent among the stroke survivors than among the control subjects until 10 years poststroke. In the stroke survivors, urinary incontinence was associated with signs of depression (OR=3.0; 95% CI, 1.3-7.1) and tended to be associated with motor function of the leg (OR=3.1; 95% CI, 0.9-10.4) and cognitive function (OR=2.8; 95% CI, 0.9-8.6). Urinary incontinence was strongly related to the number of these risk factors present ( P trend, <.001; OR=7.2; 95% CI, 2.1-24.6) in subjects having 2 or more of the risk factors, compared with subjects with none of these risk factors).

Conclusions: The prevalence of urinary incontinence is high among long-term stroke survivors, especially in subjects in whom paresis, depressive symptoms, and impaired cognition cluster.