Urgency Urinary Incontinence in Women 50 Years or Older: Incidence, Remission, and Predictors of Change

Objectives: To estimate 2-year incidence, remission, and predictors of urgency urinary incontinence (UUI) in a community-based population of women 50 years or older. Methods: We analyzed the 2004 to 2006 data in the Health and Retirement Study. Subjects were women 50 years or older with baseline and follow-up UUI information. Urgency urinary incontinence incidence and remission were calculated. Predictors of UUI progression and improvement were estimated controlling for age, ethnicity, body mass index, parity, psychiatric illness, medical comorbidities, functional limitations, and stress urinary incontinence. We evaluated whether baseline UUI status predicted follow-up status and used multivariable logistic regression to identify predictor variables. Results: A total of 8581 women reported UUI status at baseline and follow-up. Of 7244 women continent at baseline, 268 affirmed UUI at follow-up for a 2-year incidence of 3.7%. Of 581 women with UUI at baseline, 150 were continent at follow-up for a 2-year remission of 25.8%. Predictors of UUI development included increased age (7th and 10th decades compared with 6th decade; OR, 1.5 and 7.2; confidence interval [ CI], 1.1-2.1 and 4.2-12.5, respectively), obesity (OR, 1.6; CI, 1.2-2.1), history of psychiatric illness (OR, 1.6; CI, 1.3-2.0), functional limitations (OR, 6.2; CI, 4.2-9.2), and stress urinary incontinence (OR, 5.0; CI, 3.0-8.3). Women who denied UUI at baseline were also likely to deny UUI at follow-up (OR, 47.4; CI, 22.9-98.1). Conclusions: In this community-based population of women 50 years or older, UUI incidence was low and remission was high. Predictors of UUI included increased age, severe obesity, functional limitations, a positive psychiatric history, and incontinence status at baseline.