Adherence to urinary incontinence care among older adults attending geriatric outpatient clinics in Nigerian tertiary hospitals: A cross-sectional study.

BACKGROUND/OBJECTIVES: Incontinence remains a significant, under-prioritized geriatric health concern in low-resource settings. This study focused on urinary incontinence (UI) among older adults, assessing adherence to prescribed UI care and identifying associated sociodemographic and clinical factors. METHODS: A cross-sectional survey was conducted from June 2024 to April 2025 across 36 tertiary hospitals nationwide, including 1665 adults aged ≥60 years with clinically documented UI. Data were collected using a validated questionnaire adapted from the Incontinence Care Compliance Scale. Analyses included descriptive statistics, chi-square tests, and unadjusted odds ratios (ORs), with significance set at p ≤ 0.05. RESULTS: Overall, 74.5% of participants reported high adherence to UI care. Adherence was highest for incontinence product use (92.1%) and dietary/fluid recommendations (91.2%), but lowest for pelvic floor exercises (26.4%). Key barriers included embarrassment (64.6%) and financial constraints (59.3%). Higher adherence was associated with female gender (OR = 1.58; 95% CI: 1.02-2.45), tertiary education (OR = 3.77; 95% CI: 2.62-5.42), urban residence (OR = 2.06; 95% CI: 1.45-2.91), normal cognitive function (OR = 1.47; 95% CI: 1.10-1.95), and multiple chronic conditions (OR = 4.24; 95% CI: 2.96-6.07). Lower adherence was associated with age ≥71 years (OR = 0.43; 95% CI: 0.31-0.59), low income (OR = 0.21; 95% CI: 0.14-0.32), and symptom duration >6 months (OR = 0.31; 95% CI: 0.19-0.50), CONCLUSION: Adherence to UI care was relatively high but shaped by modifiable and non-modifiable factors. Targeted interventions are essential to improve UI management and health equity among older adults in resource-limited settings.