Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2010 Jul;58(7):1341-6.
doi: 10.1111/j.1532-5415.2010.02908.x. Epub 2010 Jun 1.

Incidence and risk factors for fecal incontinence in black and white older adults: a population-based study

Alayne D Markland  1 , Patricia S Goode, Kathryn L Burgio, David T Redden, Holly E Richter, Patricia Sawyer, Richard M Allman
Affiliations

Incidence and risk factors for fecal incontinence in black and white older adults: a population-based study

Alayne D Markland et al. J Am Geriatr Soc. 2010 Jul.

Abstract

Objectives: To determine the incidence of fecal incontinence (FI) in community-dwelling older adults and identify risk factors associated with incident FI.

Design: Planned secondary analysis of a longitudinal, population-based cohort study.

Setting: Three rural and two urban Alabama counties (in-home assessments 2000-2005).

Participants: Stratified random sample of 1,000 Medicare beneficiaries: 25% African-American men, 25% white men, 25% African-American women, 25% white women, aged 65 and older. Eligible participants for this analysis were continent at baseline and community-dwelling 4 years later (n=557).

Measurements: FI was defined as any loss of control of bowels occurring during the previous year. Independent variables were sociodemographics, Charlson comorbidity counts, self-reported bowel symptoms (chronic diarrhea and constipation), depression, and body mass index (BMI). Multivariable logistic regression models were constructed using incident FI as the dependent variable.

Results: The incidence rate of FI at 4 years was 17% (95% confidence interval (CI)=13.7-20.1), with 6% developing FI at least monthly (95% CI=4.0-8.3). White women were more likely to have incident FI (22%) than African-American women (13%, P=.04); no racial differences were observed in men. Controlling for age, comorbidity count, and BMI, significant independent risk factors for incident FI in women were white race, depression, chronic diarrhea, and urinary incontinence (UI). UI was the only significant risk factor for incident FI in men.

Conclusion: The occurrence of new FI is common in men and women aged 65 and older, with a 17% incidence rate over 4 years. FI and UI may share common pathophysiologic mechanisms and need regular assessment in older adults.

PubMed Disclaimer

Conflict of interest statement

Conflict of Interest: Funded by the National Institute on Aging (R01AG15062) to Richard M. Allman; P30AG031054, the Deep South Resource Center for Minority Aging Research Award; and Department of Veterans Affairs Birmingham/Atlanta Geriatric Research, Education, and Clinical Center for salary support for Alayne D. Markland, Patricia S. Goode, Kathryn L. Burgio, and Richard M. Allman. Dr. Markland was funded by the U.S. Department of Veterans Affairs, Rehabilitation Research and Development Career Development Award-2.

Figures

Figure 1
Figure 1
Participants in the University of Alabama at Birmingham Study of Aging from baseline to 4 years with data on fecal incontinence (FI).
See this image and copyright information in PMC

Comment in

References

    1. Norton C, Whitehead WE, Bliss DZ, et al. Conservative and pharmacological management of faecal incontinence in adults. In: Abrams P, Cardozo L, Khoury S, et al., editors. Incontinence. 4. Paris, France: Health Publications, Ltd; 2009. pp. 1321–1386.
    1. Bharucha AE, Zinsmeister AR, Locke GR, et al. Prevalence and burden of fecal incontinence: A population-based study in women. Gastroenterology. 2005;129:42–49. - PubMed
    1. Whitehead WE, Borrud L, Goode PS, et al. Fecal incontinence in U.S. adults: Epidemiology and risk factors. Gastroenterology. 2009;137:512–517. - PMC - PubMed
    1. Macmillan AK, Merrie AEH, Marshall RJ, et al. The prevalence of fecal incontinence in community-dwelling adults: A systematic review of the literature. Dis Colon Rectum. 2004;47:1341–1349. - PubMed
    1. Nelson R, Norton N, Cautley E, et al. Community-based prevalence of anal incontinence. JAMA. 1995;274:559–561. - PubMed

Publication types