Risk Factors for Fecal Incontinence in Older Women

OBJECTIVES: The objectives of this study were to estimate the prevalence of fecal incontinence (FI) in older women and examine associations between potential risk factors and prevalent FI. METHODS: We conducted a cross-sectional study of prevalent FI in 64,559 women, aged 62-87 years, in the Nurses' Health Study. Since 1976, participants provided information on health and lifestyle on mailed biennial questionnaires. Data on FI were collected in 2008. Adjusted odds ratios (ORs) and 95 % confidence intervals (CIs) for FI were calculated using logistic regression models. RESULTS: The reported prevalence of liquid or solid stool incontinence at least monthly increased from 9 % in women aged 62 to 64 years to 17 % in women aged 85 to 87 years. Prevalent FI was 50 % less common in black women compared with white women (6 % vs. 12 %, respectively). Other variables associated with increased odds of FI at least monthly were pregnancy, higher body mass index (BMI), lower physical activity, functional limitations, current cigarette smoking, type 2 diabetes, high blood pressure, and neurologic disease. Urinary incontinence (UI) was a strong correlate of FI, with 63 % of women with FI reporting UI at least monthly compared with 45 % of women in the whole study population. CONCLUSIONS: FI is a common condition among older women, and often co-occurs with UI. Potentially modifiable risk factors include BMI, physical activity, and cigarette smoking. Am J Gastroenterol 2013; 108:113-119; doi:10.1038/ajg.2012.364; published online 23 October 2012