%0 Journal Article %J International Urogynecology Journal %D 2016 %T Epidemiology of Mixed, Stress, and Urgency Urinary Incontinence in Middle-Aged/Older Women: the Importance of Incontinence History %A Yuko M Komesu %A Ronald M Schrader %A Loren H Ketai %A Rebecca G Rogers %A Gena C. Dunivan %K Health Conditions and Status %K Methodology %X Introduction and hypothesis Urinary incontinence (UI) is common and the relationship among its subtypes complex. Our objective was to describe the natural history and predictors of the incontinence subtypes stress, urgency, and mixed, in middle-aged and older US women. We tested our hypothesis that UI subtype history predicted future occurrence, evaluating subtype incidence/remission over multiple time points in a stable cohort of women. Methods We analyzed longitudinal urinary incontinence data in 10,572 community-dwelling women aged 50 in the 2004 2010 Health and Retirement Study. Mixed, stress, and urgency incontinence prevalence (2004, 2006, 2008, 2010) and 2-year cumulative incidence and remissions (2004 2006, 2006 2008, 2008 2010) were estimated. Patient characteristics and incontinence subtype status 2004 2008 were entered into a multivariable, transition model to determine predictors for incontinence subtype occurrence in 2010. Results The prevalence of each subtype in this population (median age 63 66) was 2.6 8.9 . Subtype incidence equaled 2.1 3.5 and remissions for each varied between 22.3 and 48.7 . Incontinence subtype incidence predictors included ethnicity/race, age, body mass index, and functional limitations. Compared with white women, black women had decreased odds of incident stress incontinence and Hispanic women had increased odds of stress incontinence remission. The age range 80 90 and severe obesity predicted incident mixed incontinence. Functional limitations predicted mixed and urgency incontinence. The strongest predictor of incontinence subtype was subtype history. The presence of the respective incontinence subtypes in 2004 and 2006 strongly predicted 2010 recurrence (odds ratio OR stress incontinence = 30.7, urgency OR = 47.4, mixed OR = 42.1). Conclusions Although the number of remissions was high, a previous history of incontinence subtypes predicted recurrence. Incontinence status is dynamic, but tends to recur over the longer term. %B International Urogynecology Journal %I 27 %V 27 %P 763-772 %G eng %U http://dx.doi.org/10.1007/s00192-015-2888-1 %N 5 %4 Incidence/Predictors/Mixed urinary incontinence/Stress urinary incontinence/Urgency urinary incontinence %$ 999999 %R 10.1007/s00192-015-2888-1 %0 Journal Article %J Female Pelvic Med Reconstr Surg %D 2011 %T Urgency urinary incontinence in women 50 years or older: incidence, remission, and predictors of change. %A Yuko M Komesu %A Ronald M Schrader %A Rebecca G Rogers %A Loren H Ketai %X

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.

%B Female Pelvic Med Reconstr Surg %I 17 %V 17 %P 17-23 %8 2011 Jan %G eng %N 1 %1 http://www.ncbi.nlm.nih.gov/pubmed/22453668?dopt=Abstract %2 PMC3042699 %4 Urinary Incontinence/WOMEN/Socioeconomic Differences/COMORBIDITY/Body Mass Index %$ 24870 %R 10.1097/SPV.0b013e31820446e6 %0 Journal Article %J Int Urogynecol J Pelvic Floor Dysfunct %D 2009 %T Incidence and remission of urinary incontinence in a community-based population of women ≥ 50 years. %A Yuko M Komesu %A Rebecca G Rogers %A Ronald M Schrader %A Cynthia M. Lewis %K Age Factors %K Black People %K disease progression %K Female %K Hispanic or Latino %K Humans %K Incidence %K Logistic Models %K Longitudinal Studies %K Middle Aged %K Odds Ratio %K Prevalence %K Remission, Spontaneous %K Severity of Illness Index %K United States %K Urinary incontinence %K White People %X

INTRODUCTION AND HYPOTHESIS: The objective of the study was to determine incidence, remission, and predictors of change in urinary incontinence in women ≥ 50 in a racially diverse population.

METHODS: Subjects were women ≥ 50 with 4-year follow-up incontinence information in the Health and Retirement Study. Women with Any UI (AUI) and Severe UI (SVUI) were evaluated. Repeated measures logistic regression determined predictors of progression to and improvement of SVUI.

RESULTS: Women (11,591) were evaluated. AUI 4-year cumulative incidence was 12.7-33.8% (fifth vs. ninth decades). SVUI incidence was lower but also increased with age. Among the predictors of improvement in SVUI were age (ninth vs. fifth decade odds ratios (OR) = 6.06) and ethnicity (Black vs. White OR = 0.57). Improvement of SVUI (45.8% overall) decreased with age (ninth vs. fifth decade OR = 0.12).

CONCLUSIONS: SVUI incidence increased and remission decreased with age. Ethnicity and age predicted SVUI progression while age predicted improvement. Rates of the latter were high, particularly in younger patients.

%B Int Urogynecol J Pelvic Floor Dysfunct %I 20 %V 20 %P 581-9 %8 2009 May %G eng %N 5 %1 http://www.ncbi.nlm.nih.gov/pubmed/19229462?dopt=Abstract %2 PMC3623953 %4 Urinary Incontinence/health Status/logistic Models/incidence %$ 69714 %R 10.1007/s00192-009-0838-5