Scott Macdiarmid, Eric Gwynn, Matteo Cesari, Jeff Williamson,

Department of Urology and Sticht Aging Center, Wake Forest University Health Sciences, Winston-Salem, NC

Introduction: It is well established that urinary incontinence significantly impacts on quality of life in the elderly population and is associated with a higher incidence of depression and fall-related fractures. However, the impact of urinary incontinence on physical function and disability has not been evaluated. We hypothesized that urinary incontinence in older women is associated with a higher prevalence of disability.

Objective: To characterize the relationship between urinary incontinence and physical function in community-dwelling non-demented older women and determine whether incontinence is associated with functional deficits.

Methods: We analyzed baseline data from the Women’s Health and Aging Study, a 3-year prospective cohort of 1002 mild to moderately disabled community-dwelling women. After adjusting for common comorbid conditions, the prevalence of self-reported physical disability and reduced performance on functional testing was compared in the continent population (n=360) to those with urinary incontinence (UI, n=642), stress incontinence (SUI, n=391), and urge incontinence (UUI, n=506).

Results: Difficulty walking across the room was reported in 25.1% of the continent patients compared with 37% (p=0.001), 28.1% (p=0.34), and 34.6% (p=0.003) of the UI, SUI, and UUI groups, respectively. On timed tests of physical function, women with UUI had significant poorer performance on the 4-meter walk speed (p=0.04) and the chair stand test (stands/sec) verses the continent population. Similar findings were demonstrated with activities of daily living.

Conclusion: This data suggests that urinary incontinence, especially those with urge incontinence, may be a risk factor for lower extremity physical disability in older women at high risk for functional decline. Further study is needed to determine whether early identification and treatment of urinary incontinence is a pathway to reducing disability and institutionalization in aging populations.

UroToday.com Coverage of SUFU 2007

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