Objective
To estimate the association between urinary incontinence and probable depression, work disability, and workforce exit.
Methods
The analytic sample consisted of 4,511 women enrolled in the population-based Health and Retirement Study cohort. The analysis baseline was 1996, the year that questions about urinary incontinence were added to the survey instrument, and at which time study participants were 54–65 years of age. Women were followed with biennial interviews until 2010–2011. Outcomes of interest were onset of probable depression, work disability, and workforce exit. Urinary incontinence was specified in different ways based on questions about experience and frequency of urine loss. We fit Cox proportional hazards regression models to the data, adjusting the estimates for baseline socio-demographic and health status variables previously found to confound the association between urinary incontinence and the outcomes of interest.
Results
At baseline, 727 participants (survey-weighted prevalence, 16.6 percent; 95% confidence interval [CI], 15.4–18.0) reported any urinary incontinence, of which 212 (survey-weighted prevalence, 29.2 percent; 95% CI, 25.4–33.3) reported urine loss on more than 15 days in the past month; and 1,052 participants were categorized as having probable depression (survey-weighted prevalence, 21.6 percent; 95% CI, 19.8–23.6). Urinary incontinence was associated with increased risks for probable depression (adjusted hazard ratio [AHR], 1.43; 95% CI, 1.27–1.62) and work disability (AHR, 1.21; 95% CI, 1.01–1.45) but not workforce exit (AHR, 1.06; 95% CI, 0.93–1.21).
Conclusions
In a population-based cohort of women between the ages of 54 and 65, urinary incontinence was associated with increased risks for probable depression and work disability. Improved diagnosis and management of urinary incontinence may yield significant economic and psychosocial benefits.