More than half of female nursing home residents have bladder control problems even though only a fraction are diagnosed with incontinence, a new report has found.

An analysis of the 1999 National Nursing Home Survey showed that a total of 58.6% of all the women were reported to have difficulty controlling urination. More than half needed assistance in using the toilet. But only 1.4% of the residents had been diagnosed with urinary incontinence. The survey collected information from 1,500 facilities.

Incontinence is defined in this study context as leakage of the urine and need for assistance using the toilet. The study suggests that incontinence is more prevalent than residents’ medical records indicate, said Dr. Jennifer Anger of the University of California in Los Angeles.