Journals of Gerontology Series A: Biological Sciences and Medical Sciences, Vol 54, Issue 1 M34-M37, Copyright © 1999 by The Gerontological Society of America

JOURNAL ARTICLE

Communication between older adults and their physicians about urinary incontinence

SJ Cohen, D Robinson, E Dugan, G Howard, PK Suggs, KF Pearce, DD Carroll, P McGann and J Preisser
Department of Public Health Sciences, Wake Forest University School of Medicine, Winston-Salem, North Carolina, USA. [email protected]

BACKGROUND: Urinary incontinence (UI) is a common but undertreated condition in older adults. The study objective was to determine older patients' characteristics related to communication patterns with their physicians about UI. METHODS: Telephone surveys of a sample of patients age 60 and older who visited a primary care provider (PCP) for any reason within the past 2 months were conducted. Participating physicians included general internists and family physicians from 41 primary care practices located in the 17 counties of 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 initiating a discussion of incontinence if not asked by their PCP. RESULTS: Age and gender were significant independent predictors of incontinence. PCPs were significantly more likely to assess incontinent women than incontinent men (21% vs 10%, p = .053). The older cohorts of older adults were significantly more likely to be symptomatic for UI than their younger counterparts. However, the younger cohorts were more likely to be screened for incontinence by their physicians. CONCLUSIONS: Despite the publication of guidelines on improving the screening and management of UI, the problem remains common and underdetected in older 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.

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