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Functional Disability and Compromised Mobility Among Older Women With Urinary Incontinence

Erekson, Elisabeth A. MD, MPH*†; Ciarleglio, Maria M. PhD; Hanissian, Paul D. MD*; Strohbehn, Kris MD*; Bynum, Julie P.W. MD, MPH; Fried, Terri R. MD§∥

Female Pelvic Medicine & Reconstructive Surgery: May/June 2015 - Volume 21 - Issue 3 - p 170–175
doi: 10.1097/SPV.0000000000000136
Original Articles

Objective Our objective was to determine the prevalence of functional disability among older women with urinary incontinence (UI).

Methods We conducted a secondary analysis of the 2005–2006 National Social Life, Health and Aging Project. Daily UI was defined as answering “daily” to the question, “How frequently…have you had difficulty controlling your bladder, including leaking small amounts of urine, leaking when you cough or sneeze, or not being able to make it to the bathroom on time?” We then explored functional status. Women were asked about 7 basic activities of daily living (ADLs). Statistical analyses with percentage estimates and 95% confidence intervals (CIs) were performed. Logistic regression was performed to assess the association between functional status and daily UI.

Results In total, 1412 women were included in our analysis. Daily UI was reported by 177 (12.5%) women. Functional dependence or disability with any activities of daily living was reported in 62.1% (95% CI, 54.2%–70.1%) of women with daily UI. Among women with daily UI, 23.6% (95% CI, 16.8%–30.5%) reported specific difficulty or dependence with using the toilet, signifying functional limitations which may contribute to urine leakage. After adjusting for age category, race/ethnicity, education level, and parity, women with daily UI had 3.31 increased odds of functional difficulty or dependence compared with continent older women.

Conclusions More than 60% of older women with daily UI reported functional difficulty or dependence and one fourth of women with daily UI specifically reported difficulty or dependence with using the toilet.

Functional disability is common among community-dwelling older women with urinary incontinence.

From the*Department of Obstetrics and Gynecology, and †The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH; ‡Yale Center for Analytical Sciences, Yale University School of Public Health; §Department of Medicine, Yale University School of Medicine, New Haven; and ∥Clinical Epidemiology Research Center, VA Connecticut Healthcare System, West Haven, CT.

Reprints: Elisabeth A. Erekson, MD, MPH, Division of Urogynecology, Geisel School of Medicine at Dartmouth, 1 Medical Center Dr, Lebanon, NH 03756. E-mail:

No reprints available.

The authors have declared they have no conflicts of interest.

This research was supported by a grant from the American Urogynecologic Society (AUGS) Foundation. Dr Erekson was supported in part through a grant from the Claude D. Pepper Older Americans Independence Center at Yale University School of Medicine (NIH/NIA #P30AG021342). The National Social Life, Health and Aging Project was conducted by a grant from the National Institute on Aging (NIH/NIA #R01 AG021487).

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