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墨西哥社区居住的老年成年人中尿失禁的流行病学、进展和预测因素:来自墨西哥健康和老龄化研究的纵向数据。

Epidemiology, progression, and predictive factors of urinary incontinence in older community-dwelling Mexican adults: Longitudinal data from the Mexican Health and Aging Study.

机构信息

Demographic Epidemiology and Social Determinants Department, National Institute of Geriatrics, Mexico City, Mexico.

Politics, Population and Health Research Center, School of Medicine, National Autonomous University of Mexico, Mexico City, Mexico.

出版信息

Neurourol Urodyn. 2019 Sep;38(7):1932-1943. doi: 10.1002/nau.24096. Epub 2019 Jul 11.

Abstract

AIMS

To understand the epidemiology, progression, and predictive factors of urinary incontinence (UI) in community-dwelling Mexican adults aged ≥ 50 by sex and UI subtypes (stress, urge, and mixed).

METHODS

We analyzed longitudinal UI data in community-dwelling adults aged ≥ 50 (7783 women and 5843 men) for the 2012 to 2015 period of the Mexican Health and Aging Study. We estimated mixed, stress, and urgency incontinence prevalence (2012); 2-year cumulative incidence and remissions (2015); and progression (2012-2015). A multivariate analysis was undertaken to evaluate the predictive factors for UI and its subtypes by sex.

RESULTS

The prevalence of UI was higher (27.7%) for women (average age 65.9 ± 9.5) than 12.5% men (average age 67.4 ± 9.3) and increased with age in both sexes (26.7% in women 50 to 59, to 48.5% in ≥ 90; and 6.8% in men 50 to 59, to 26.2% ≥ 90). The most frequent UI subtypes were mixed in women and urge in men. The cumulative incidence of UI was higher in women (22.9%) than men (12.3%) while its remission was higher in men than women. Predictive factors for UI in both sexes were depressive symptoms, a higher number of concomitant diseases and a history of falls; while advanced age was a factor only for men.

CONCLUSIONS

UI is a common health problem and its prevalence and severity increase with age. Addressing modifiable risk factors such as depression and falls could decrease the prevalence and incidence of UI and its subtypes. Further studies should also focus on the relationship between mixed UI and male mortality.

摘要

目的

按性别和尿失禁(UI)亚型(压力性、急迫性和混合性)了解墨西哥≥50 岁社区居住成年人的 UI 流行病学、进展和预测因素。

方法

我们分析了 2012 年至 2015 年期间墨西哥健康与老龄化研究中≥50 岁社区居住成年人的纵向 UI 数据(7783 名女性和 5843 名男性)。我们估计了 2012 年混合性、压力性和急迫性尿失禁的患病率;2015 年的 2 年累积发病率和缓解率;以及 2012-2015 年的进展情况。采用多变量分析评估了性别与 UI 及其亚型的预测因素。

结果

女性 UI 患病率(27.7%)高于男性(平均年龄 65.9±9.5)的 12.5%,且在两性中随年龄增长而增加(女性 50-59 岁为 26.7%,≥90 岁为 48.5%;男性 50-59 岁为 6.8%,≥90 岁为 26.2%)。最常见的 UI 亚型是女性的混合性和男性的急迫性。女性 UI 的累积发病率(22.9%)高于男性(12.3%),而男性 UI 的缓解率高于女性。两性 UI 的预测因素均为抑郁症状、更多的并存疾病和跌倒史;而年龄较大仅为男性的一个因素。

结论

UI 是一个常见的健康问题,其患病率和严重程度随年龄增长而增加。解决抑郁和跌倒等可改变的危险因素可能会降低 UI 及其亚型的患病率和发病率。进一步的研究还应关注混合性 UI 与男性死亡率之间的关系。

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