Is There an Association between Urinary Incontinence and Mortality? A Retrospective Cohort Study

被引:14
作者
Matta, Rano [1 ]
Hird, Amanda E. [1 ]
Saskin, Refik [2 ,4 ]
Radomski, Sidney B. [1 ]
Carr, Lesley [1 ]
Kodama, Ronald T. [1 ]
Nam, Robert K. [3 ,5 ,6 ]
Herschorn, Sender [1 ]
机构
[1] Div Urol, Toronto, ON, Canada
[2] Inst Hlth Policy Management & Evaluat, Toronto, ON, Canada
[3] Univ Toronto, Toronto, ON, Canada
[4] Inst Clin Evaluat Sci, Toronto, ON, Canada
[5] Sunnybrook Hlth Sci Ctr, 2075 Bayview Ave, Toronto, ON M4N 3M5, Canada
[6] Univ Hlth Network, Div Urol, Toronto, ON, Canada
基金
加拿大健康研究院;
关键词
urinary bladder; urinary incontinence; frailty; mortality; nutrition surveys; NURSING-HOME ADMISSION; OVERACTIVE BLADDER; FRAILTY; PREVALENCE; WOMEN; RISK; DEPRESSION; SYMPTOMS; FITNESS; PEOPLE;
D O I
10.1097/JU.0000000000000574
中图分类号
R5 [内科学]; R69 [泌尿科学(泌尿生殖系疾病)];
学科分类号
1002 ; 100201 ;
摘要
Purpose: Previous studies have shown an association between urinary incontinence and increased mortality independently of demographics and health status. However, they do not account for the effect of frailty as a state of vulnerability. We evaluated whether there is an association between urinary incontinence and mortality and, if so, whether adjustment for a frailty index would affect the association. Materials and Methods: We performed a cross-sectional study in a nationally representative sample of 2,282 community dwelling individuals 50 years old or older who were surveyed between 2003 and 2006. The study primary outcome was overall survival as reported on December 31, 2011. We used design adjusted Cox proportional hazards regression models to estimate the hazard of mortality associated with urinary incontinence. We adjusted the models for demographics and a validated 45-item frailty index incorporating an accumulation of deficits in the domains of health and independence. Results: Of the individuals 23% reported having urinary incontinence at least a few times per week. Stress urinary incontinence and urge urinary incontinence were associated with a 13.3% (95% CI 7.2-19.7) and 18.4% (95% CI 8.3-29.4) increase in the frailty index, respectively. Without controlling for frailty individuals with urinary incontinence were at higher risk for death (HR 1.39, 95% CI 1.13-1.72). When adjusted for the frailty index, the association between urinary incontinence and mortality was no longer significant (HR 1.10, 95% CI 0.89-1.36). Conclusions: The association between urinary incontinence and mortality can be understood based on increased frailty in incontinent individuals. Urinary incontinence itself is not independently associated with mortality. In clinical practice these findings underscore the importance of screening for frailty in addition to urinary incontinence.
引用
收藏
页码:591 / 597
页数:7
相关论文
共 29 条
[1]   Frailty in NHANES: Comparing the frailty index and phenotype [J].
Blodgett, Joanna ;
Theou, Olga ;
Kirkland, Susan ;
Andreou, Pantelis ;
Rockwood, Kenneth .
ARCHIVES OF GERONTOLOGY AND GERIATRICS, 2015, 60 (03) :464-470
[2]   The Association of Lower Urinary Tract Symptoms, Depression and Suicidal Ideation: Data from the 2005-2006 and 2007-2008 National Health and Nutrition Examination Survey [J].
Breyer, Benjamin N. ;
Kenfield, Stacey A. ;
Blaschko, Sarah D. ;
Erickson, Bradley A. .
JOURNAL OF UROLOGY, 2014, 191 (05) :1333-1339
[3]   Urinary incontinence: Does it increase risk for falls and fractures? [J].
Brown, JS ;
Vittinghoff, E ;
Wyman, JF ;
Stone, KL ;
Nevitt, MC ;
Ensrud, KE ;
Grady, D .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2000, 48 (07) :721-725
[4]   Urodynamic findings in women with insensible incontinence [J].
Brucker, Benjamin M. ;
Fong, Eva ;
Kaefer, Daniela ;
Shah, Sagar ;
Rosenblum, Nirit ;
Nitti, Victor W. .
INTERNATIONAL JOURNAL OF UROLOGY, 2013, 20 (04) :429-433
[5]   Risk factors for urinary incontinence among middle-aged women [J].
Danforth, KN ;
Townsend, MK ;
Lifford, K ;
Curhan, GC ;
Resnick, NM ;
Grodstein, F .
AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 2006, 194 (02) :339-345
[6]   Association between the Geriatric Giants of urinary incontinence and falls in older people using data from the Leicestershire MRC Incontinence Study [J].
Foley, Anne L. ;
Loharuka, Shankar ;
Barrett, James A. ;
Mathews, Ruth ;
Williams, Kate ;
McGrother, Catherine W. ;
Roe, Brenda H. .
AGE AND AGEING, 2012, 41 (01) :35-40
[7]   The association between lower urinary tract symptoms and falls: Forming a theoretical model for a research agenda [J].
Gibson, William ;
Hunter, Kathleen F. ;
Camicioli, Richard ;
Booth, Joanne ;
Skelton, Dawn A. ;
Dumoulin, Chantale ;
Paul, Lorna ;
Wagg, Adrian .
NEUROUROLOGY AND URODYNAMICS, 2018, 37 (01) :501-509
[8]   URETHRAL PRESSURE PROFILES IN CONTINENT AND STRESS-INCONTINENT WOMEN [J].
HENRIKSSON, L ;
ANDERSSON, KE ;
ULMSTEN, U .
SCANDINAVIAN JOURNAL OF UROLOGY AND NEPHROLOGY, 1979, 13 (01) :5-10
[9]   Urinary incontinence and its association with death, nursing home admission, and functional decline [J].
Holroyd-Leduc, JM ;
Mehta, KM ;
Covinsky, KE .
JOURNAL OF THE AMERICAN GERIATRICS SOCIETY, 2004, 52 (05) :712-718
[10]  
Hoover M, 2013, HEALTH REP, V24, P10