ObjectiveTo examine the occurrence, attitudes, and knowledge of urinary incontinence (UI) among older women in a rural setting.DesignClient questionnaire.Settings and SubjectsA randomly selected sample of community-dwelling women aged 55 years and older living in a rural midwestern state.InstrumentParticipants completed several instruments, including an Incontinence Survey that queried primarily demographic data, an Incontinence Quiz that queried knowledge and attitudes toward UI, and specific questions related to its clinical and psychosocial consequences.MethodsThe questionnaire was mailed to 300 women whose names had been randomly selected from a seniors' group mailing list.Main Outcome MeasureThe prevalence of UI among a group of community-dwelling older women as well as attitudes and knowledge concerning incontinence.ResultsOne hundred twenty women returned the questionnaire, providing a response rate of 40%. Three of the 120 respondents were excluded because they did not answer the question pertaining to UI status. Of the 117 who did respond, 79 (67.5%) reported UI. Most of the respondents with incontinence categorized their UI as minor (81.9%), and 88% denied that incontinence had a significant impact on their lifestyle. Thirty-seven percent of the incontinent women sought treatment. When questioned about UI, over half of the 117 respondents incorrectly indicated that incontinence is a normal result of advanced age. Almost one third of the respondents incorrectly believed that most people become incontinent by the time they reach the age of 85.ConclusionsMisconceptions concerning the causes of and the availability of treatment for incontinence among community-dwelling women may have an impact on their decision to seek care for this typically remediable condition.