Total, somatic, and cognitive-affective depressive symptoms trajectories and urinary incontinence: Evidence from two national longitudinal cohorts.

BACKGROUND: Depression is increasingly recognized as a potential contributor to urinary incontinence (UI). Unlike single time-point assessments, longitudinal trajectories of depressive symptoms may yield deeper insights into their relationship with UI. This study examined the association between long-term depressive symptom trajectories and UI.

METHODS: We included participants with complete data from the Health and Retirement Study (HRS) and the English Longitudinal Study of Ageing (ELSA). UI was defined as any involuntary leakage within the past 12 months. Depressive symptoms were measured using the 8-item CES-D and categorized into somatic and cognitive-affective. Group-based trajectory modeling (GBTM) was used to identify long-term trajectories of depressive symptoms. We applied generalized estimating equations (GEE) to assess the association between depressive symptom trajectories and UI.

RESULTS: A total of 6345 participants from HRS and 2218 from ELSA were included. Participants with moderate (OR = 1.22, 95% CI: 1.06-1.40) and severe (OR = 1.30, 95% CI: 1.11-1.53) trajectories of total depressive symptoms were significantly associated with UI in HRS, and a significant association was also observed for severe depressive symptoms in ELSA (OR = 1.62, 95% CI: 1.20-2.18), compared to participants without depressive symptoms. Both somatic and cognitive-affective depressive symptoms trajectories were significantly associated with UI.

CONCLUSION: Longitudinal trajectories of depressive symptoms are significantly associated with UI. Different dimensions of depressive symptoms, including somatic and cognitive-affective symptoms, showed distinct associations with UI. Further studies are needed to clarify the specific mechanisms underlying these relationships and to assess their potential relevance for UI prevention in older adults.