Department of Medicine, Division of Gerontology, Geriatrics and Palliative Care, University of Alabama-Birmingham UAB School of Medicine, Birmingham, AL, USA.
Birmingham/Atlanta VA Geriatric Research, Education and Clinical Center, Birmingham VA Medical Center, Birmingham, AL, USA.
BJU Int. 2018 Dec;122(6):1041-1048. doi: 10.1111/bju.14246. Epub 2018 May 9.
To identify patterns of prevalent chronic medical conditions among women with urinary incontinence (UI).
We combined cross-sectional data from the 2005-2006 to 2011-2012 US National Health and Nutrition Examination Surveys, and identified 3 800 women with UI and data on 12 chronic conditions. Types of UI included stress UI (SUI), urgency UI (UUI), and mixed stress and urgency UI (MUI). We categorized UI as mild, moderate or severe using validated measures. We performed a two-step cluster analysis to identify patterns between clusters for UI type and severity. We explored associations between clusters by UI subtype and severity, controlling for age, education, race/ethnicity, parity, hysterectomy status and adiposity in weighted regression analyses.
Eleven percent of women with UI had no chronic conditions. Among women with UI who had at least one additional condition, four distinct clusters were identified: (i) cardiovascular disease (CVD) risk-younger; (ii) asthma-predominant; (iii) CVD risk-older; and (iv) multiple chronic conditions (MCC). In comparison to women with UI and no chronic diseases, women in the CVD risk-younger (age 46.7 ± 15.8 years) cluster reported the highest rate of SUI and mild UI severity. In the asthma-predominant cluster (age 51.5 ± 10.2 years), women had more SUI and MUI and more moderate UI severity. Women in the CVD risk-older cluster (age 57.9 ± 13.4 years) had the highest rate of UUI, along with more severe UI. Women in the MCC cluster (age 61.0 ± 14.8 years) had the highest rates of MUI and the highest rate of moderate/severe UI.
Women with UI rarely have no additional chronic conditions. Four patterns of chronic conditions emerged with differences by UI type and severity. Identification of women with mild UI and modifiable conditions may inform future prevention efforts.
确定患有尿失禁（UI）的女性中常见慢性疾病的模式。
我们结合了 2005-2006 年至 2011-2012 年美国国家健康和营养检查调查的横断面数据，并确定了 3800 名患有 UI 且有 12 种慢性疾病数据的女性。UI 的类型包括压力性 UI（SUI）、急迫性 UI（UUI）和混合性压力和急迫性 UI（MUI）。我们使用经过验证的措施将 UI 分为轻度、中度或重度。我们进行了两步聚类分析，以确定 UI 类型和严重程度之间的聚类模式。我们在加权回归分析中控制年龄、教育程度、种族/民族、生育次数、子宫切除术状态和肥胖，以探索亚组之间与 UI 严重程度相关的关联。
11%的 UI 女性没有任何慢性疾病。在患有至少一种其他疾病的 UI 女性中，发现了四个不同的聚类：（i）心血管疾病（CVD）风险-年轻型；（ii）哮喘为主型；（iii）CVD 风险-老年型；和（iv）多种慢性疾病（MCC）型。与没有慢性疾病的 UI 女性相比，CVD 风险年轻型（年龄 46.7 ± 15.8 岁）聚类报告了最高的 SUI 发生率和轻度 UI 严重程度。在哮喘为主型聚类（年龄 51.5 ± 10.2 岁）中，女性患有更多的 SUI 和 MUI，且 UI 严重程度更严重。CVD 风险老年型聚类（年龄 57.9 ± 13.4 岁）的女性 UUI 发生率最高，同时 UI 严重程度也最高。MCC 聚类（年龄 61.0 ± 14.8 岁）的女性患有最高的 MUI 发生率和最高的中度/重度 UI 发生率。
患有 UI 的女性很少没有其他慢性疾病。出现了四种慢性疾病模式，其特点是 UI 类型和严重程度不同。确定患有轻度 UI 和可改变条件的女性可能会为未来的预防工作提供信息。
