Urinary incontinence: common problem among women over 45.

OBJECTIVE To examine age-specific prevalence and correlates of urinary incontinence (UI) among community-dwelling women.

DESIGN A questionnaire survey used a modified Dillman method.

SETTING Two family practice clinics in Hamilton, Ont.

PARTICIPANTS Questionnaires were mailed to 1082 women 45 years old and older. Ninety women were disqualified; 606 recipients responded.

MAIN OUTCOME MEASURES Self-reported prevalence of UI and potential risk factors.

RESULTS Overall response rate was 61% (606/992); 51% (311/606; 95% confidence interval 47.3% to 55.3%) reported an episode of UI during the last month. Of the 311 women reporting UI, 35.7% perceived it as a problem, 27% had had it for less than a year, 41.9% had had it for 1 to 4 years, and 31.1% had had it for 5 years or longer. Three kinds of UI were reported: 34% (106/311) reported stress UI, 14.5% (45/311) reported urge UI, and 51.4% (160/311) reported a mixed pattern. In multivariate analysis, the overall prevalence of incontinence increased significantly with "usually having a cough," "being troubled by swollen ankles," "giving birth," "ever smoking cigarettes," and "being troubled by headaches." Stress UI was associated with "usually having a cough" and "ever smoking cigarettes." Urge UI was associated with "having troubles with constipation" and "swollen ankles." Mixed incontinence was associated with "get sick more than other people," "usually having a cough," "taken hormones for menopause," and body mass index in the 50th to 75th percentile or greater. Age was not significantly associated with prevalence of UI or any of its subtypes. Only 40% of incontinent women indicated they had discussed urine loss with their physicians; 70% of these women felt satisfied with physicians' responses.

CONCLUSION Incontinence occurs in more than half of community-dwelling women 45 years old and older. Almost one of five women in the community reported UI that affected normal activities. Treating the effect of incontinence will require further understanding of women's coping skills and self-perceptions. Prevalence does not appear to increase with age.