Predictors of urinary and faecal incontinence in pre-frail and frail older adults: a cross-sectional study of the FRAGSALUD project

Abstract Background Frailty is associated with urinary and faecal incontinence, which are common geriatric syndromes. This study aims to identify health factors associated with incontinence in pre-frail or frail older adults living in the community. Methods This multicentre cross-sectional study included 225 older adults (75.0±6.4 years) with pre-frailty or frailty based on the five-component Fried phenotype. Physical function was assessed using the Short Physical Performance Battery (SPPB). Physical activity, inactivity, and sleep were estimated using a wrist-worn accelerometer. Urinary or faecal incontinence was registered using the Barthel scale (urine and bowel items). Multivariable logistic regression analyses, with age as a covariate, were conducted to identify associations of incontinence. Results In our participants, 27% presented urinary or faecal incontinence with no sex differences (P=0.266). Our results showed that age, daily medication count, and number of falls in the previous year independently predicted incontinence in frail and pre-frail older adults (P<0.05). Some Fried’s criteria, including self-reported exhaustion, gait speed, and handgrip strength were associated with the presence of incontinence (P<0.05), but not Fried’s classification. The SPPB total score and its isolated variables were significantly associated with the urinary and faecal incontinence (P<0.05). However, none of the accelerometer outcomes showed significant associations with incontinence status. Conclusions According to this study, age, number of medications, and falls (but not sex) are linked to urinary and faecal incontinence in frail or pre-frail older adults living in the community, recommending the assessment of physical function using the SPPB rather than estimating daily physical activity, inactivity, or sleep.