Epidemiology of Faecal Incontinence for People with Dementia Living in the Community in New Zealand: A Retrospective Cohort Study Using interRAI Home Care Assessment Data

Abstract

Abstract BACKGROUND Globally there are few studies but wide variation in epidemiology of faecal incontinence (FI) for people living with dementia in the community. Our objectives are to identify 1-year period prevalence, 5-year incidence, and risks for faecal incontinence (FI) for people living with dementia. METHODS A retrospective cohort study comprising International Residential Assessment Instrument Home Care version (interRAI-HC) assessments in a 5-year period in New Zealand (N = 109964). For prevalence analysis, we selected a dementia cohort for a 1-year period from 1 Aug 2020 to 31 July 2021 (n = 7775). For the incidence analysis, participants in the dementia cohort were followed up from the day of the first dementia diagnosis during the period 1 Aug 2016 and 31 July 2021. Dementia was identified by combining diagnosis of “Alzheimer's disease” and “Dementia other than Alzheimer's disease”. Participants were coded with faecal incontinence if they were continent with a stoma, seldom incontinent, occasionally incontinent, often incontinent and incontinent. RESULTS 1 year period (1 Aug 2020-31 July 2021) prevalence of FI was 26.7% (2082/7775) of PLWD. 5-year incident FI rate was 19.0 per 100 person years for PLWD and 12.3 per 100 person years for people without dementia. Controlling for risk factors for FI in both groups the hazard ratio for FI was 1.7 for PLWD. CONCLUSIONS FI affects a significant proportion of people with dementia in NZ. interRAI-HC data could facilitate global epidemiological studies to estimate service or intervention need for people with dementia to redress or manage FI.