Original Article
Predictive model of fecal or urinary incontinence among older adults in China
Li Lin, Chen Feilong, Li Xiaoyan, Gao Yiyuan, Zhu Silin, Diao Xiyezi, Wang Ning, Xu Tao
Published 2023-06-14
Cite as Chin J Geriatr, 2023, 42(6): 726-732. DOI: 10.3760/cma.j.issn.0254-9026.2023.06.019
Abstract
ObjectiveTo construct and validate a predictive model of fecal/urinary incontinence among older adults in China.
MethodsData was obtained from the Seventh Chinese Longitudinal Healthy Longevity Survey in 2018.In the questionnaire, "Are you able to control your bowel and urine" , was regarded as the main effect indicator.Receiver operating curves(ROC)were used to find the best cut-off values of calf circumference for predicting fecal/urinary incontinence, and univariate Logistic model method was used to explore the potential factors associated with fecal/urinary incontinence among community-living older adults in China.A random sampling method was used to extract 70% of the survey data as the training set, and the remaining 30% of the survey data as the test set.A multivariate Logistic regression analysis was conducted in the training set to build a prediction model that encompassed all predictors, and a nomogram was plotted.
ResultsLogistic regression analysis showed that age, small calf circumference(male <28.5 cm, female <26.5 cm), inability to walk 1 km continuously, inability to lift 5 kg items, inability to do three consecutive squats, limited daily activities, and a history of urinary system disorders, nervous system disorders, and cerebrovascular disorders were all risk factors for fecal/urinary incontinence for older adults in China.Female, better socioeconomic status, and normal body mass index were protective factors for fecal/urinary incontinence.The Logistic regression model for predicting fecal/urinary incontinence among Chinese older adults was constructed using the above twelve factors.The consistency index(C-index)value of the model was 0.907, indicating that the model had good predictive ability.The area under the ROC curve(AUC)of the overall sample, training set and test set were 0.906(95%CI: 0.896-0.917), 0.907(95 %CI: 0.894-0.921)and 0.910(95%CI: 0.892-0.928), respectively, indicating that the model had high prediction ability and good discrimination.
ConclusionsAge, sex, calf circumference, ability to walk 1 km continuously, ability to lift 5 kg items, ability to do three consecutive squats, daily activities, history of urinary system disorders, nervous system disorders and cerebrovascular disorders, socioeconomic status, and body mass index were independent predictors for fecal/urinary incontinence among older adults in China.The nomogram based on the above indicators has a good predictive effect on fecal/urinary incontinence for older adults.
Key words:
Urinary incontinence; Fecal incontinence; Forecasting; Nomograms
Contributor Information
Li Lin
Clinical Medical Center, National Research Institute for Family Planning, Beijing 100081, China
Chen Feilong
Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences &
Peking Union Medical College, Beijing 100005, China
Li Xiaoyan
Center for Health Quality, National Research Institute for Family Planning, Beijing 100081, China
Gao Yiyuan
Center for Health Quality, National Research Institute for Family Planning, Beijing 100081, China
Zhu Silin
Department of Statistics, Central China Normal University, Wuhan 430079, China
Diao Xiyezi
Department of Statistics, Central China Normal University, Wuhan 430079, China
Wang Ning
Center for Health Quality, National Research Institute for Family Planning, Beijing 100081, China
Xu Tao
Department of Epidemiology and Statistics, Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences &
Peking Union Medical College, Beijing 100005, China
