Jackson R A, Vittinghoff E, Kanaya A M, Miles T P, Resnick H E, Kritchevsky S B, Simonsick E M, Brown J S
Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, USA.
Obstet Gynecol. 2004 Aug;104(2):301-7. doi: 10.1097/01.AOG.0000133482.20685.d1.
To estimate the prevalence of and risk factors for stress and urge incontinence in a biracial sample of well-functioning older women.
We performed a cross-sectional analysis of 1,584 white and black women, aged 70-79 years, enrolled in a longitudinal cohort study. Participants were asked about incontinence, medical problems, and demographic and reproductive characteristics and underwent physical measurements. Using multivariable logistic regression, we compared women reporting at least weekly incontinence with those without incontinence.
Overall, 21% reported incontinence at least weekly. Of these, 42% reported predominantly urge incontinence, and 40% reported stress. Nearly twice as many white women as black women reported weekly incontinence (27% versus 14%, P <.001). Factors associated with urge incontinence included white race (odds ratio [OR] 3.1, 95% confidence interval [CI] 2.0-4.8), diabetes treated with insulin (OR 3.5, 95% CI 1.6-7.9), depressive symptoms (OR 2.7, 95% CI 1.4-5.3), current oral estrogen use (OR 1.7, 95% CI 1.1-2.6), arthritis (OR 1.7, 95% CI 1.1-2.6), and decreased physical performance (OR 1.6 per point on 0-4 scale, 95% CI 1.1-2.3). Factors associated with stress incontinence were chronic obstructive pulmonary disease (OR 5.6, 95% CI 1.3-23.2), white race (OR 4.1, 95% CI 2.5-6.7), current oral estrogen use (OR 2.0, 95% CI 1.3-3.1), arthritis (OR 1.6, 95% CI 1.0-2.4), and high body mass index (OR 1.3 per 5 kg/m2, 95% CI 1.1-1.6).
Urinary incontinence is highly prevalent, even in well-functioning older women, whites in particular. Many risk factors differ for stress and urge incontinence, suggesting differing etiologies and prevention strategies.
评估功能良好的老年女性双种族样本中压力性尿失禁和急迫性尿失禁的患病率及危险因素。
我们对纳入纵向队列研究的1584名年龄在70 - 79岁的白种和黑种女性进行了横断面分析。研究对象被问及尿失禁情况、医疗问题、人口统计学和生殖特征，并接受体格检查。使用多变量逻辑回归，我们比较了每周至少有一次尿失禁报告的女性与无尿失禁的女性。
总体而言，21%的女性报告每周至少有一次尿失禁。其中，42%主要报告急迫性尿失禁，40%报告压力性尿失禁。报告每周尿失禁的白人女性数量几乎是黑人女性的两倍（27%对14%，P <.001）。与急迫性尿失禁相关的因素包括白种人（比值比[OR] 3.1，95%置信区间[CI] 2.0 - 4.8）、胰岛素治疗的糖尿病（OR 3.5，95% CI 1.6 - 7.9）、抑郁症状（OR 2.7，95% CI 1.4 - 5.3）、当前口服雌激素使用（OR 1.7，95% CI 1.1 - 2.6）、关节炎（OR 1.7，95% CI 1.1 - 2.6）以及身体功能下降（0 - 4级量表上每降低1分，OR 1.6，95% CI 1.1 - 2.3）。与压力性尿失禁相关的因素有慢性阻塞性肺疾病（OR 5.6，95% CI 1.3 - 23.2）、白种人（OR 4.1，95% CI 2.5 - 6.7）、当前口服雌激素使用（OR 2.0，95% CI 1.3 - 3.1）、关节炎（OR 1.6，95% CI 1.0 - 2.4）以及高体重指数（每5 kg/m²，OR 1.3，95% CI 1.1 - 1.6）。
尿失禁非常普遍，即使在功能良好的老年女性中也是如此，尤其是白人女性。压力性尿失禁和急迫性尿失禁的许多危险因素不同，提示病因和预防策略存在差异。
