While a very small proportion of female nursing home residents are diagnosed with urinary incontinence, more than half actually have prblems with bladder control, researchers report.

Incontinence - defined in this context not only by leakage of urine but also by the need for assistance in using the toilet - can lead to medical complications such as bed sores and urinary tract infections, according to Dr. Jennifer Anger, from the University of California in Los Angeles.

Residents’ medical records indicate that the prevalence of incontinence among women in US nursing homes is only 1 to 2 percent, Anger and colleagues report in the medical journal Urology.

“However, when you then ask caregivers or patients if they have difficulty controlling their urination, or if they needed assistance in using the toilet, you realize that proportions are extremely different,” Anger told Reuters Health.

“It shows that very few doctors focus on incontinence or even address the issue, and there needs to be better inquiry to patients,” she added.

To compare administrative versus clinical estimates of the prevalence of incontinence, Anger’s team examined data from the 1999 National Nursing Home Survey, which collected information from 1500 facilities.

The analysis showed that less than 1.4 percent of female nursing home residents had been diagnosed with urinary incontinence. On the other hand, 58.6 percent of all the women were reported to have difficulty controlling urination, and more than one half needed assistance in using the toilet.

“This shows that the prevalence is much higher than their medical records show, and it highlights the limitations of using administrative data to study the epidemiology of bladder dysfunction,” Anger noted.

SOURCE: Urology, February 2006.