Association between Life's Essential 8 and mortality in urinary incontinence among US female adults.

BACKGROUND

Urinary incontinence (UI) may be associated with cardiovascular disease. Life's Essential 8 (LE8), a recently updated measure of cardiovascular health (CVH), has been investigated for its association with all-cause and cardiovascular mortality among US female adults with UI.

METHODS

This population-based retrospective cohort study utilised data from 6314 US female adults aged ≥20 years with UI (weighted population: 4.14 million) derived from the National Health and Nutrition Examination Survey (NHANES) 2005-2018, along with their linked mortality data up to December 2019. The LE8 metric, ranging from 0 to 100, was categorised into low, moderate, and high levels. UI status was determined by self-report. Multivariable Cox proportional hazards regression models were employed to assess the associations between LE8 and both all-cause and cardiovascular disease (CVD) mortality. A stratified analysis and sensitivity analysis were also conducted.

RESULTS

During a median follow-up period of 92 months (with a maximum of 180 months) among US adult females with UI, 684 all-cause deaths were recorded, including 169 deaths attributable to cardiovascular disease. A 10-point increase in the LE8 score was associated with a 14% reduction in the risk of all-cause mortality (hazard ratio [HR], 0.86; 95% confidence interval [CI], 0.79-0.93) and a 17% reduction in the risk of CVD mortality (HR, 0.83; 95% CI, 0.71-0.97). Physical activity has the most significant effect. In the stratified subgroups and sensitivity analyses, the results remained robust.

CONCLUSIONS

An elevated LE8 score was independently correlated with reduced risks of all-cause and cardiovascular mortality among US female adults with UI. Future prospective studies are required to further strengthen our findings.