Prevalence and Detection of Urinary Incontinence among Older Medicaid Recipients

Low-income older adults have higher rates of many medical disorders than those with higher income, but rates of urinary incontinence have not been examined in this population. A random sample of older Medicaid recipients was interviewed (n=910) and medical records examined for the subset with urinary incontinence (n=236). Nursing home residents were randomly selected from Medicaid enrollment files (n=480). Forty-two percent of community residents reported urinary incontinence, with higher rates among women, older respondents, and whites. The medical records for only 22% of community-dwellers contained a diagnosis of urinary incontinence, compared with 77% for nursing home residents. Type of urinary incontinence was specified for 65% of diagnosed community dwellers and 7% of diagnosed nursing home residents. Urinary incontinence rates are high among Medicaid recipients compared with estimates from general population studies, but detection rates are lower for community-dwellers. Physicians may need to do more among low-income older adults in order to detect urinary incontinence.