Association between chronic conditions and urinary incontinence in females: a cross-sectional study using national survey data

Abstract

Background: Urinary incontinence affects up to half of women, yet few speak to their health care provider about or receive treatment for the condition. To aid with identifying subpopulations at risk for urinary incontinence, we examined the associations between 10 chronic health conditions and urinary incontinence among Canadian adult females. Methods: We conducted a cross-sectional analysis of survey data from the Canadian Community Health Survey (2013–2014) involving female respondents aged 25 years or older living in a private dwelling. Presence of chronic conditions and urinary incontinence were measured by self-report. We used logistic regression modelling with sampling weights, controlling for age, income, ethnicity, body mass index and smoking. Multiple imputation and probabilistic bias analysis were used to address missing covariate data and unmeasured confounding from parity. Results: Our analysis included 60 186 respondents representing more than 12 million Canadian females, of whom 45.8% (95% confidence interval [CI] 45.0%–46.6%) reported at least 1 chronic condition. Chronic conditions were associated with more than twice the odds of urinary incontinence (adjusted odds ratio [OR] 2.42, 95% CI 2.02–2.89). Associations were largest for bowel disorders (adjusted OR 2.92, 95% CI 2.44–3.49); modest for chronic obstructive pulmonary disease (adjusted OR 2.00, 95% CI 1.63–2.45), asthma (adjusted OR 1.82, 95% CI 1.52–2.19), arthritis (adjusted OR 1.98, 95% CI 1.74–2.24) and heart disease (adjusted OR 1.73, 95% CI 1.48–2.02); and smallest for diabetes (adjusted OR 1.20, 95% CI 1.02–1.41) and high blood pressure (adjusted OR 1.27, 95% CI 1.12–1.44). Results slightly attenuated but did not substantively change after imputation and bias analysis. Interpretation: We found that chronic conditions are associated with significantly higher odds of comorbid urinary incontinence among Canadian adult females, which is consistent with previous research. Our findings support routine inquiry regarding urinary incontinence symptoms among women accessing health care for chronic conditions.

Multimorbidity associated with urinary incontinence among older women and men with complex needs in Aotearoa | New Zealand

“…From 15 core variables, 77.9% of participants had ≥2 conditions. This rate is considerably higher than the 20.2%-50.5% multimorbidity rates reported elsewhere, 6,7,14 and likely reflects the older aged cohort with complex needs participating here. It also empirically demonstrates the increased longevity and improved survival from acute conditions which has resulted in more older adults living with multiple longterm health conditions.…”

“…Based on the bladder incontinence question, UI was then dichotomised into continent (complete control; response "0") and incontinent (any episodes; responses "2," "3," "4," "5") groups, as has been employed elsewhere. 6,7,14,20 Previous research supports the validity and high accuracy of self-reported UI. 21 Motivated by Ho et al 12 multimorbidity was defined to capture (where possible) their core set of 20 chronic conditions.…”

“…1.82, 2.42) in younger Canadian females 14 ; and adjusted OR = 1.30 (95% CI: 1.14, 1.48) for English females and males combined. 6 While the diverse participant compositions likely explains some of these differences, multimorbidity was not rare in any of these studies.…”

“…They also acknowledge the need for consensus studies to finalize core and study-dependent conditions to include in measures of multimorbidity. 12 While recent investigations into the relationship between UI and multimorbidity have considerable strengths, 6,7,14 they also suffer from methodological shortcomings. The selection of conditions and measures employed are discordant, as could be expected in the absence of consensus studies and agreement.…”

Factors Associated With Urgency Urinary Incontinence Among Older Mexican American Women Aged 65 years and Older

“…The association between smoking and incontinence has been studied, with possible causes including the development of chronic obstructive pulmonary disease (COPD) leading to cough-related incontinence and increased peak pressure caused by coughing in chronic smokers ( Fuganti et al, 2011 ). Arthritis may be an associated factor in women because of overactive bladder that comes with age or mobility disability ( Scime et al, 2022 ; Tsai & Liu, 2009 ; Turner-Stokes & Frank, 1992 ). Cognition and physical disabilities have also been shown to be associated with incontinence as they decline, possibly due to an inability to reach the bathroom in a timely manner in those with physical disabilities ( Schumpf et al, 2017 ).…”