Incontinence, Frailty and Care Needs in Community-Dwelling Older Adults: Findings from an ICPOP Community Specialist Team

Abstract Background Incontinence is a common condition among older adults and has been linked to adverse outcomes such as falls, infections, psychological distress, functional decline, institutionalisation, and caregiver burden. Despite its clinical significance, the impact of incontinence among community-dwelling older adults in Ireland remains poorly characterised. This study aimed to evaluate and compare the clinical characteristics and care-related outcomes of older adults with incontinence with those who are continent, using data from comprehensive geriatric assessments (CGA) conducted by an Integrated Care Programme for Older Persons (ICPOP) community specialist team (CST). Methods This was a retrospective cross-sectional study involving older adults who underwent CGA over a six-month period. Data was collected on continence status, demographic and clinical characteristics, functional ability, and caregiver involvement. Emergency department presentations and hospital admissions within 90 days of CGA were recorded. Incontinence was defined as the presence of either urinary or bowel incontinence. Statistical analysis was performed using STATA v18.0. Results Of the 146 participants, 76 (52%) were classified as incontinent. Compared to continent individuals, those with incontinence had significantly lower Barthel scores (median 85 vs 95, p < 0.001) and higher levels of frailty (median CFS 6 vs 5, p < 0.001). Incontinence was significantly associated with the presence of a carer (p = 0.012). No significant differences were observed in age, acute care utilisation, or socioeconomic indicators. Conclusion Incontinence was highly prevalent in this cohort and associated with greater frailty, functional dependence, and increased presence of caregivers. These findings highlight the need for early identification and proactive management of incontinence, and for investment in multidisciplinary supports. Efforts should also recognise and support the essential role of both formal and informal caregivers in enabling older adults with incontinence to remain living at home safely and with dignity.