URINARY-INCONTINENCE IN RURAL OLDER WOMEN - PREVALENCE, INCIDENCE ANDREMISSION

OBJECTIVES: To determine the prevalence, incidence, and remission rate s of urinary incontinence in a large group of older women over a 6-yea r time span and to assess factors associated with incontinence inciden ce and remission. DESIGN: Longitudinal cohort study SETTING: Two rural counties in Iowa PARTICIPANTS: 2025 women aged 65 years or older resi ding in rural Iowa, enrolled in the Iowa 65+ Rural Health Study of EPE SE (Establishment of Populations for Epidemiologic Studies of the Elde rly) were interviewed in person annually for 6 years; specific respons es to queries about urinary incontinence were given at baseline, 3-, a nd 6-year intervals. MEASUREMENTS: Conditional multivariate logistic r egression analysis was done to assess the relationship between inconti nence symptoms and various factors previously found to be related to i ncontinence. RESULTS: The baseline prevalence of urge incontinence was 36.3%, and of stress incontinence it was 40.3%. For urge incontinence ,the 3-year incidence and remission rates between the third and sixth years were 28.5% and 22.1%, respectively. For stress incontinence, the 3-year incidence and remission rates between years 3 and 6 were 28.6% and 25.1%, respectively. Seventy-six percent and 84% of women who rep orted no urge or stress incontinence, respectively, at the baseline in terview were continent at both follow-up interviews. The only signific ant factors related to changes in incontinence status were age, which was associated with an increased incidence of urge incontinence (OR 1. 11, P = .017, 95% CI 1.019-1.203), and improvement in activities of da ily living, which was associated with a increased remission of urge in continence (OR 0.50, P = .015, 95% CT 0.28-0.9) CONCLUSION: In some ol der women, urinary incontinence is a dynamic state, with women moving back and forth along a continuum between continence and incontinence. These results are tempered by limitations of the study, which include its questionnaire design and lack of ability to detect potential treat ment effect.