Advancing Nursing Education and Practice for Future Global Health
Vol. 13 No. 4 (2025): Advancing Nursing Education and Practice for Future Global Health

Depression among older people living in the community with urinary, fecal, and double incontinence in Bali, Indonesia: a secondary data analysis

Publisher's note
All claims expressed in this article are solely those of the authors and do not necessarily represent those of their affiliated organizations, or those of the publisher, the editors and the reviewers. Any product that may be evaluated in this article or claim that may be made by its manufacturer is not guaranteed or endorsed by the publisher.
Received: 12 May 2025
Accepted: 9 September 2025
Published: 2 October 2025
148
Views
104
Downloads
1
HTML

Authors

Depression and incontinence in older people living at home have become a global issue; however, the research around this area is limited in Indonesia. This study aimed to determine the prevalence of depression among older people with Urinary Incontinence (UI), Fecal Incontinence (FI), and Double Incontinence (DI) in Indonesia. This study used data from a community project dataset for case management processes in older people in an urban area of Bali in 2022. The dataset used was 970 older people aged 60+. We measured six variables in our study: age, gender, depression, UI, FI, and DI. A multivariate logistic regression analysis was conducted to explore the determinants of depression in older people. Most respondents were female (55.3%). Findings showed that the prevalence of depression, urinary, fecal, and double incontinence were 8.0%, 4.7%, 9.1%, and 2.8%, respectively. Depression was associated with age and all types of incontinence, but not gender. Logistic regression showed that the strongest predictor of depression in older people was FI (OR 3.151), followed by age, with OR 2.243. Nurses and other health workers should conduct more active screening for depres- sion and incontinence for better management of these global health issues.

Downloads

Download data is not yet available.

Citations

1. Papageorgiou A, Bakola M, Kitsou K, et al. The association between depression and quality of life in the elderly. Eur J Public Health 2022;32:ckac131.25. DOI: https://doi.org/10.1093/eurpub/ckac131.125
2. Suyasa I, Sutini NK, Kamaryati NP, Nuryanto IK. Determinant of functional disability in instrumental activities of daily living among elderly living in a rural area in Bali: a cross-sectional study. J Ners 2023;18:110-6. DOI: https://doi.org/10.20473/jn.v18i2.45700
3. Marwati M, Ruswati R, Trihandayani Y, Kasmad K. Physical activity mediated the relationship between depressive symptoms and physical frailty and among community-dwelling older adults in Indonesia. Malays J Med Health Sci 2024;20:287-94.
4. Abebe SA, Gashaw F, Tsegaye A, et al. Prevalence and determinants of depression among women with urinary incontinence: a systematic review and meta-analysis worldwide. BMC Women's Health 2024;24:591. DOI: https://doi.org/10.1186/s12905-024-03432-1
5. Wang Y, Li N, Zhou Q, Wang P. Fecal incontinence was associated with depression of any severity: insights from a large cross-sectional study. Int J Colorectal Dis 2023;38:271. DOI: https://doi.org/10.1007/s00384-023-04563-x
6. Shon D, Kim SJ, Cheon E-J, Kang SI, Kim S. Prevalence and risk factors associated with depressive mood in Korean patients with fecal incontinence. Ann Surg Treat Res 2021;101:181-6. DOI: https://doi.org/10.4174/astr.2021.101.3.181
7. Zhang Y. The effect of incontinence on depression among older adults: a longitudinal study in China. Public Health 2022;212:58-65. DOI: https://doi.org/10.1016/j.puhe.2022.08.018
8. Corral-Pérez J, Ávila-Cabeza-de-Vaca L, Valero-Cantero I, et al. Predictors of urinary and fecal incontinence in prefrail and frail older adults: a cross-sectional study of the FRAGSALUD project. J Gerontol Series A 2024;79:glae072. DOI: https://doi.org/10.1093/gerona/glae072
9. Jerez-Roig J, Farrés-Godayol P, Yildirim M, et al. Prevalence of urinary incontinence and associated factors in nursing homes: a multicentre cross-sectional study. BMC Geriatr 2024;24:169. DOI: https://doi.org/10.1186/s12877-024-04748-1
10. Mack I, Hahn H, Gödel C, et al. Global prevalence of fecal incontinence in community-dwelling adults: a systematic review and meta-analysis. Clin Gastroentero Hepatol 2024;22:712-31. DOI: https://doi.org/10.1016/j.cgh.2023.09.004
11. Abe T, Matsumoto S, Kunimoto M, Hachiro Y, Ota S, Ohara K, Inagaki M, Saitoh Y, Murakami M. Prevalence of double incontinence and lower urinary tract symptoms in patients with fecal incontinence: a single-center observational study. J Anus Rectum Colon 2024;8:30-8. DOI: https://doi.org/10.23922/jarc.2023-040
12. Chatterton C. Incontinence: living with a stigmatised health condition. Br J Community Nurs 2024;29:340-6. DOI: https://doi.org/10.12968/bjcn.2024.0070
13. Filipas DK, Labban M, Beatrici E, et al. Association of urinary incontinence and depression: findings from the national health and nutrition examination survey. Urology 2023;181:11-7. DOI: https://doi.org/10.1016/j.urology.2023.08.008
14. Gibson W, Johnson T, Kirschner-Hermanns R, et al. Incontinence in frail elderly persons: report of the 6th international consultation on incontinence. Neurourol Urodyn 2021;40:38-54. DOI: https://doi.org/10.1002/nau.24549
15. Assmann S, Keszthelyi D, Breukink S, Kimman M. Living with faecal incontinence: a qualitative investigation of patient experiences and preferred outcomes through semi-structured interviews. Qual Life Res 2024;33:3121-9. DOI: https://doi.org/10.1007/s11136-024-03756-3
16. Mahoney FI, Barthel DW. Functional evaluation: the barthel index. Md State Med J 1965;14:61-5. DOI: https://doi.org/10.1037/t02366-000
17. Hoyl MT, Alessi CA, Harker JO, et al. Development and testing of a five-item version of the Geriatric Depression Scale. J Am Geriatr Soc 1999;47:873-8. DOI: https://doi.org/10.1111/j.1532-5415.1999.tb03848.x
18. Jacob L, Tanislav C, Kostev K. Multiple sclerosis and incidence of urinary and fecal incontinence in almost 9,000 patients followed up for up to 10 years in Germany. Neuroepidemiology 2021;55:92-9. DOI: https://doi.org/10.1159/000513234
19. Najafi Z, Morowatisharifabad MA, Jambarsang S, Rezaeipandari H, Hemayati R. Urinary incontinence and related quality of life among elderly women in Tabas, South Khorasan, Iran. BMC Urol 2022;22:214. DOI: https://doi.org/10.1186/s12894-022-01171-9
20. Shaw C, Wagg A. Urinary and faecal incontinence in older adults. Med 2021;49:44-50. DOI: https://doi.org/10.1016/j.mpmed.2020.10.012
21. Akobundu UN, Onuzulu MS, Obiekwe SJ, Akosile CO, Daniel JA, Nwankwo MJ, Ochiabuto OM. Prevalence of urinary incontinence and knowledge of pelvic floor muscle training among older women in a Nigerian suburban community. Womens Health (Lond) 2024;20:17455057241276255. DOI: https://doi.org/10.1177/17455057241276255
22. Batmani S, Jalali R, Mohammadi M, Bokaee S. Prevalence and factors related to urinary incontinence in older adults women worldwide: a comprehensive systematic review and meta-analysis of observational studies. BMC Geriatr 2021;21:212. DOI: https://doi.org/10.1186/s12877-021-02135-8
23. Tamanini JTN, Franceschi Júnior O, Santos JLF, et al. Fecal incontinence: incidence and risk factors from the SABE (Health, Wellbeing and Aging) study. Int Urogynecol J 2022;33:2993-3004. DOI: https://doi.org/10.1007/s00192-021-04914-8
24. Kessler M, Volz PM, Bender JD, Nunes BP, Machado KP, Saes MO, Soares MU, Facchini LA, Thumé E. Effect of urinary incontinence on negative self-perception of health and depression in elderly adults: a population-based cohort. Erratum in: Cien Saude Colet 2022;27:2955. DOI: https://doi.org/10.1590/1413-81232022276.10462021
25. Lee H-y, Rhee Y, Choi KS. Urinary incontinence and the association with depression, stress, and self-esteem in older Korean Women. Sci Rep 2021;11:9054. DOI: https://doi.org/10.1038/s41598-021-88740-4
26. Suyasa IGPD, Xiao LD, Lynn PA, Skuza PP, Paterson J. Prevalence of faecal incontinence in community‐dwelling older people in B ali, I ndonesia. Australas J Ageing 2015;34:127-33. DOI: https://doi.org/10.1111/ajag.12141
27. Pasricha T, Staller K. Fecal incontinence in the elderly. Clin Geriatr Med 2021;37:71-83. https://doi.org/10.1016/j.cger.2020.08.006 DOI: https://doi.org/10.1016/j.cger.2020.08.006
28. Meng L, Xu R, Li J, et al. The silent epidemic: exploring the link between loneliness and chronic diseases in China's elderly. BMC Geriatr 2024;24:710. DOI: https://doi.org/10.1186/s12877-024-05163-2
29. Kotwal AA, Cenzer IS, Waite LJ, et al. The epidemiology of social isolation and loneliness among older adults during the last years of life. J Am Geriatr Soc 2021;69:3081-91. DOI: https://doi.org/10.1111/jgs.17366
30. Handajani YS, Schröder-Butterfill E, Hogervorst E, et al. Depression among older adults in Indonesia: Prevalence, role of chronic conditions and other associated factors. Clin Pract Epidemiol Ment Health 2022;18:e174501792207010. DOI: https://doi.org/10.2174/17450179-v18-e2207010

How to Cite



Depression among older people living in the community with urinary, fecal, and double incontinence in Bali, Indonesia: a secondary data analysis. (2025). Healthcare in Low-Resource Settings, 13(4). https://doi.org/10.4081/hls.2025.13975