Prevalência de incontinência fecal e seu impacto sobre a qualidade de vida em indivíduos com 65 anos ou mais, moradores de 16 cidades brasileiras

Abstract

Introduction: the aging of the Brazilian population is associated with the increase in chronic health conditions. Fecal incontinence (FI), one of these conditions, is characterized by the involuntary loss of feces or the inability to maintain control of the anal sphincter. Its prevalence can range from 2 to 36.2% in the community and, in long-term care facilities for the elderly, it can reach 50%. In Brazil, IF is little studied, although for its patients it is loaded with great social stigma, probably having a strong impact on their quality of life. The aim of the present study was to estimate the prevalence of FI, the factors associated with it and its impact on the quality of life of individuals aged 65 years and over who live in the community. Materials and methods: community sample from the database of the Fragility in Elderly Brazilians study - Fibra-BR. This is a cross-sectional and multicenter study carried out in 16 Brazilian cities, from 2009 to 2010, to characterize frailty profiles among elderly people living in the community. The identification of IF was done through self-report of fecal loss, with the inclusion in the survey questionnaire of the following question: “In the last 12 months, did you present fecal incontinence or involuntary loss of feces?”. Results: the sample consisted of 6,855 individuals; of this total, 66.6% were female, 52.9% white, mean age 73.5 years, 61.2% had up to 4 years of schooling and 46.5% had an income of up to 1 minimum wage. The prevalence of IF was 5.9% and was associated with worse self-care [OR 1.35 (1.10-1.65)], dependence on basic activities of daily living (BAVD) [OR 2 .18 (1.21--3.93)], presence of frailty [OR 1.23 (1.01-1.51)] and UI [OR 4.21 (3.28-5.40)]. Furthermore, it was seen that some factors were negatively associated with IF. They are polypharmacy [OR 0.6 (0.43-0.74)] and independence for instrumental activities of daily living (IADL) [OR 0.71 (0.54-0.93)]. Conclusions: the calculated prevalence of FI was 5.9% and, among the outcomes studied, only the proxy variable of quality of life – worse care for one's own health – was significantly associated with FI. Other factors of known causal bidirectionality also showed a significant association, some as risk – ABVD, frailty and urinary incontinence (UI) – others as a protective factor – the use of a small number of drugs and independence in IADL