FI affects approximately 1 in 7 older adults globally, with the greatest burden in long-term care settings. Extreme residual heterogeneity limits generalizability and is strongly suggestive of methodological inconsistencies as the predominant drivers. Improving detection and comparability necessitates harmonized case definitions (International Continence Society and International Urogynecological Association) and validated instruments (Fecal Incontinence Severity Index) in research. In clinical practice, particularly long-term care, a brief 2-step screening (eg, Bristol Stool Form, International Consultation on Incontinence Questionnaire-Bowel) at admission and regular reviews is advisable, with an electronic health record flag to trigger conservative bowel management and specialist referral as needed.
Zhong et al. (2026) studied this question.