Urinary Incontinence Is an Independent Risk Factor for Nursing Home Placement among Assisted Living Residents.

Urinary incontinence severity was not measured, so severe UI may have driven placement independently of the diagnosis itself. UI was identified from claims diagnoses, so residents with incontinence who were not diagnosed may have been missed, and diagnosed residents may represent more severe cases. The study could not measure whether residents received active continence treatment; a urologist visit alone did not capture treatment. Medicare Advantage enrollees were excluded, so the findings may not apply to a growing part of the assisted living population. Residents may be embarrassed by UI and avoid seeking care, which can undercount UI prevalence. Because this was an observational study, unmeasured factors such as frailty, family preferences, or care needs could explain part of the association.

The authors reported no conflicts of interest. The article is listed as supported by non-U.S. government and NIH extramural research support.

Do not read the 14% higher placement probability as proof that treating urinary incontinence will prevent nursing home placement. The study only identified claims diagnoses and could not measure severity, underdiagnosis, or actual continence treatment.