Evidence suggests that race affects the prevalence and incidence of urinary incontinence (UI) in women. But little is known about racial differences in the rates of remission, improvement, and progression of UI in women.
We sought to compare changes in UI frequency over two years among Asian, black, and white women with UI.
Participants in the Nurses' Health Study and the Nurses' Health Study II responded to mailed questionnaires (in 2000 and 2002, and 2001 and 2003, respectively), giving information on race and the frequency of UI. Prospective analyses were conducted over two years from data gathered on 57,900 women, ages 37 to 79, who had at least monthly UI at baseline.
Over the two two-year study periods, black women were significantly more likely than white women to report remission of UI (14% versus 9%, respectively), and Asian women were significantly more likely than white women to report less frequent UI (40% versus 31%, respectively). Improvement was more common in older black women than in older white women, but rates of improvement were comparable between younger black and younger white women. Black women were less likely than white women to report more frequent UI at follow-up (30% versus 34%, respectively), and, after adjusting for health and lifestyle factors, the difference was borderline statistically significant.
Changes in the frequency of UI appear to vary by race, even after adjustment for risk factors. These findings may account for some of the previously observed differences in UI prevalence across racial groups. Although UI is a common condition in women of all races, nurses and other clinicians should be aware that its presentation may vary according to race. Such an understanding could increase clinicians' confidence in discussing UI with patients, reducing the possibility that the condition goes unrecognized.
epidemiology, progression, race, remission, urinary incontinence
Clinicians should be aware that the natural history of urinary incontinence may vary in women according to race.
Mary K. Townsend is an instructor at Brigham and Women's Hospital and Harvard Medical School, Boston, where Gary C. Curhan and Francine Grodstein are associate professors of medicine. Neil M. Resnick is a professor of medicine at the University of Pittsburgh, Pittsburgh, PA. This research was supported by grants DK62438, CA87969, and CA50385 from the National Institutes of Health. Contact author: Mary K. Townsend, firstname.lastname@example.org. The authors have disclosed no significant ties, financial or otherwise, to any company that might have an interest in the publication of this educational activity.