Urinary incontinence is associated with an increase in falls: a systematic review

Question: Is urinary incontinence associated with falls in community-dwelling older people? Design: A systematic review and meta-analysis of observational studies investigating falls and urinary incontinence. Participants: Community-dwelling older people. Outcome measures: Falls rather than fracture or injury, and any type of urinary incontinence. Results: Odds ratios of nine studies were included in the meta-analysis. The odds of falling were 1.45 (95% CI 1.36 to 1.54) in the presence of any type of urinary incontinence. The odds of failing were 1.54 (95% CI 1.41 to 1.69) in the presence of urge incontinence. The odds of falling were 1.11 (95% CI 1.00 to 1.23) in the presence of stress incontinence. The odds of falling were 1.92 (95% CI 1.69 to 2.18) in the presence of mixed incontinence. Conclusion: Urge urinary incontinence, but not stress urinary incontinence, is associated with a modest increase in falls. Falls prevention programs need to include an assessment of incontinence and referral for interventions to ameliorate the symptoms of urge incontinence. [Chiarelli PE, Mackenzie LA, Osmotherly PG (2008) Urinary incontinence is associated with an increase in falls: a systematic review. Australian Journal of Physiotherapy 55: 89-95]