Hagan KA, et al. - Researchers intended to describe the course of urinary incontinence symptoms over time with data collected over 10 years using 2 large cohorts of middle-age and older women. Symptoms of incident urinary incontinence were observed for over 10 years in most women, however, few showed complete remission. For urinary incontinence progression, identification of risk factors, such as body mass index and physical activity, could be important for reducing symptoms over time.

Methods

• Between 2002-3, the researchers studied 9,376 women from the Nurses’ Health Study, aged 56-81 years at baseline, and 7,491 women from Nurses’ Health Study II, aged 39-56 years, with incident urinary incontinence.
• They measured urinary incontinence severity by the Sandvik severity index.
• Persistence, progression, remission, and improvement of symptoms over 10 years were tracked.
• Further, they analyzed risk factors for urinary incontinence progression using logistic regression models.

Results

• At onset, 39% women had slight, 45% had moderate, and 17% had severe urinary incontinence among women age 39-56 years.
• With regard to its severity, slight urinary incontinence was noted in 34% women, moderate in 45% , and severe in 21% at the onset, among women age 56-81 years.
• Most women reported persistence or progression of symptoms over follow-up across ages; few (3-11%) reported remission.
• However, younger women and women presented with less severe urinary incontinence at onset were more likely to report remission or improvement of symptoms.
• The researchers found that only among older women, increasing age correlated with higher odds of progression (age 75-81 vs 56-60 years, odds ratio=1.84, 95% confidence interval: 1.51, 2.25).
• Higher body mass index was strongly associated with progression among all women (younger women: Odds ratio=2.37, 95% confidence interval: 2.00, 2.81 body mass index ≥30 vs < 25 kg/m²; older women: Odds ratio=1.93, 95% confidence interval: 1.62, 2.22).
• Greater physical activity was also related to lower odds of progression to severe urinary incontinence (younger women: odds ratio=0.86, 95% confidence interval: 0.71, 1.03, highest vs lowest quartile of activity; older women: Odds ratio=0.68, 95% confidence interval: 0.59, 0.80).