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ORIGINAL RESEARCH |
¶
From the *Department of Obstetrics, Gynecology and Reproductive Sciences, the Department of Epidemiology and Biostatistics, and the Division of General Internal Medicine, Department of Medicine, University of California, San Francisco; the Department of Family and Community Medicine, University of Louisville, Louisville, Kentucky; ¶MedStar Research Institute, Washington, DC; ||J. Paul Sticht Center on Aging, Wake Forest University Health Sciences Medical Center, Winston-Salem, North Carolina; and the *Intramural Research Program, National Institute on Aging, Baltimore, Maryland.
Address reprint requests to: Rebecca Jackson, MD, San Francisco General Hospital, Department of Obstetrics and Gynecology, #6D, 1001 Potrero Avenue, San Francisco, CA 94110; e-mail: jacksonr{at}obgyn.ucsf.edu.
OBJECTIVE: To estimate the prevalence of and risk factors for stress and urge incontinence in a biracial sample of well-functioning older women.
METHODS: We performed a cross-sectional analysis of 1,584 white and black women, aged 70–79 years, enrolled in a longitudinal cohort study. Participants were asked about incontinence, medical problems, and demographic and reproductive characteristics and underwent physical measurements. Using multivariable logistic regression, we compared women reporting at least weekly incontinence with those without incontinence.
RESULTS: Overall, 21% reported incontinence at least weekly. Of these, 42% reported predominantly urge incontinence, and 40% reported stress. Nearly twice as many white women as black women reported weekly incontinence (27% versus 14%, P < .001). Factors associated with urge incontinence included white race (odds ratio [OR] 3.1, 95% confidence interval [CI] 2.0–4.8), diabetes treated with insulin (OR 3.5, 95% CI 1.6–7.9), depressive symptoms (OR 2.7, 95% CI 1.4–5.3), current oral estrogen use (OR 1.7, 95% CI 1.1–2.6), arthritis (OR 1.7, 95% CI 1.1–2.6), and decreased physical performance (OR 1.6 per point on 0–4 scale, 95% CI 1.1–2.3). Factors associated with stress incontinence were chronic obstructive pulmonary disease (OR 5.6, 95% CI 1.3–23.2), white race (OR 4.1, 95% CI 2.5–6.7), current oral estrogen use (OR 2.0, 95% CI 1.3–3.1), arthritis (OR 1.6, 95% CI 1.0–2.4), and high body mass index (OR 1.3 per 5 kg/m2, 95% CI 1.1–1.6).
CONCLUSION: Urinary incontinence is highly prevalent, even in well-functioning older women, whites in particular. Many risk factors differ for stress and urge incontinence, suggesting differing etiologies and prevention strategies.
LEVEL OF EVIDENCE: II-2
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