The association of depressive symptoms and urinary incontinence among older adults

OBJECTIVES: To examine the relationship of urinary incontinence (UI) and de pressive symptoms (DS) in older adults. DESIGN: A randomized, controlled trial to determine the effects of clinical practice guideline implementation on provider attitudes and behavior, and patients' UI, health status, quality of life, and satisfaction with care. B aseline and endpoint data were collected from patients via computer-assiste d telephone interviewing. SETTING: Forty-one nonacademic primary care practices (PCP) in North Caroli na. PARTICIPANTS: A total of 668 community-dwelling adults (age > 60) who had v isited the one of the selected PCPs. INTERVENTION: PCPs in the intervention group were given instruction in the detection and management of UI, educational materials for providers and pat ients, office system supports, and academic detailing. MEASUREMENTS: The dependent measure was assessed using an eight-item screen er for DS. UI (status, frequency, amount), health (physical, mental), and d emographic (age, gender, marital status) and self-report information about bladder control served as predictors. RESULTS: Wilcoxon rank sum tests showed that UI status was associated with moderate to severe DS (43% vs 30%, P = .05). Multivariate analyses showed t hat UI status, physical and mental health, and gender were significant pred ictors of DS. Among UI adults (n = 230), physical and mental health, life s atisfaction, and the perception that UI interfered with daily life were sig nificant predictors of DS. CONCLUSIONS: This study provides clear evidence that UI is related to DS in older adults.