At least one in eight Canadians aged 65 and older suffered from urinary incontinence when surveyed in 2008-09, a new report from Statistics Canada reveals. And one of the authors of the study says the problem is almost certainly larger than the survey results suggest.
Data for the study were drawn from the 2008-09 Canadian Community Health Survey – Healthy Aging, which polled 16,369 adults 65 and older. Their answers are deemed to be reflective of about 4.4-million people in Canada.
The survey asked respondents whether they had been diagnosed with urinary incontinence. And Heather Gilmour, an author and a senior analyst in Statistic Canada's health analysis division, said there is good reason to believe many people with the condition never raise it with their doctors so would never get an official diagnosis.
"Studies have shown that people really don't discuss this with their health-care providers. They might think that there's nothing that can be done or they might be embarrassed or they might just think that it's a normal part of aging," Gilmour said in an interview.
Had the question been framed differently – if, for instance, it asked whether respondents had trouble with bladder control – the figures might have been higher, she said.
As well, the survey only polled seniors living in the community – either in their own homes or with relatives. Those typically would be the healthiest of seniors. If seniors living in long-term care facilities had been included in the survey, the rates would likely have been higher, Gilmour said.
As it is, 14 per cent of women and nine per cent of men aged 65 and older reported having urinary incontinence. And rates were higher still among adults 85 and older; 22 per cent of women and nearly 19 per cent of men reported suffering from urinary incontinence.
While the design of this study cannot prove cause and effect – in this case that urinary incontinence causes loneliness – it provides evidence the conditions may be linked.
Seniors who reported having incontinence were about 50 per cent more likely to report loneliness than those who didn't suffer from the condition, Gilmour said.
The problem of incontinence is "huge," according to Dr. Donna Fedorkow, a professor of obstetrics and gynecology at McMaster University in Hamilton. Fedorkow specializes in urogynecology and runs a weekly clinic for women 70 and older who suffer from the condition.
She says there are multiple causes, including aging muscles, the effects of childbirth, interactions of medications and circulatory problems. As well, the quantity and quality of a person's fluid intake can have an influence. Too many caffeinated drinks exacerbate the problem, but so too can drinking too few fluids.
"I suppose it's true: The more you drink, the more you pee. But if you under-drink, the urine becomes very concentrated and very irritating to the bladder and can actually precipitate problems," Fedorkow said.
Fedorkow said a lot of her patients find the condition very upsetting. "They're concerned about odour. They have the impression that everyone else knows that they're having these continence issues."
"A lot of women will say that they know where every single bathroom is in every single shopping mall in the city, because they don't want to be caught in a situation where they don't know where they can go to the washroom."
The study concludes that addressing the problem of urinary incontinence in seniors would have a positive impact on their lives.
"To me it represents a situation where seniors and their health-care providers can be more aware and understand 'Well, this is a very prevalent problem but there's a lot that can be done about it that might have a positive impact on seniors's quality of life,"' Gilmour said.