The Prevalence of Incontinence in People with Cognitive Impairment or Dementia Living at Home: a Systematic Review

Aims: To investigate the prevalence of urinary and fecal incontinence in people with cognitive impairment or dementia, living at home.

Method: We searched electronic databases, MEDLINE, EMBASE, CINAHL, PsycINFO, BNI, and the Cochrane Library (including DARE, NTIS), from January 1, 1990 to 2012 week 13 (April 4) for studies reporting prevalence data of urinary and fecal incontinence in the population of interest. Quality assessments of studies considered risk of bias in criteria for prevalence studies. Due to the heterogeneity of the included study populations and results, meta-analysis was not appropriate and a narrative analysis was undertaken.

Results: From 427 references, eight studies met the inclusion criteria. Seven studies provided prevalence rates as findings incidental to their primary question. Populations and assessment tools were varied. Reported prevalence of urinary incontinence ranged from 1.1% in a general community population to 38% in those receiving home care services. Reported rates of fecal incontinence were from 0.9% in a community population to 27% in a population attending an old age psychiatry outpatient clinic.

Conclusions: The prevalence of incontinence in people with dementia or cognitive impairment living at home has not been clearly established. Population level data is required to inform clinicians and to reliably underpin decision-making in service planning, resource allocation and interventions for people with dementia and incontinence.