OBJECTIVE: We sought to identify the prevalence of urinary incontinence (Ul) and lower urinary tract symptoms (LUTS) and to evaluate the risk factors of community-dwelling South Korean elders for developing Ul. DESIGN: We undertook a cross-sectional study based on interviews using a structured questionnaire. SETTING AND SUBJECTS: One hundred thirty-five community-dwelling elders, aged 85 years and older residing in 9 villages of Jeju Island, South Korea, were interviewed. Of 218 persons registered by the provincial government, interviews with 135 (62%) persons were completed. METHODS: Between April 5, 2004 and May 31, 2004, a researcher or 1 of 3 research assistants visited each subject's home. The interview took approximately 40 minutes to complete. Data were recorded by a research assistant and interviews were performed by the primary investigator or research assistant. INSTRUMENTS: LUTS severity was assessed by the Korean version of the international Prostate Symptom Score (IPSS) Q items), and 3 additional items that specifically queried Urinary Incontinence (UI). Cognitive function and depression were assessed using the Korean version of the Mini Mental State Examination (MMSE-K) (13 items) and Geriatric Depression Scale Short Form Korean Version (GDSSF-K) (15 items). RESULTS: Forty-seven elderly (34.8%) reported Ul more than once a week during the prior 12 months. Mixed Ul symptoms were reported by 29 subjects (61.7%), pure urge Ul symptoms by 16 (34.0%), and pure stress Ul symptoms by 2 respondents (4.3%). The mean IPSS score of the subjects was 6.0 +/- 6.3 (range: 0-35). Risk factors for developing Ul were moderate (odds ratio (OR) 17.6; 95% confidence interval (Cl) 6.97-45.30) and severe LUTS (OR 36.5; 95% Cl 3.86-345.07) measured by the IPSS. CONCLUSIONS: Ul was found to affect 34.8% (47) of the community-dwelling elders 85 years or older in this study and mixed Ul symptoms were predominant. LUTS was associated with an increased risk of Ul.