Brown J S, Seeley D G, Fong J, Black D M, Ensrud K E, Grady D
Department of Obstetrics, Gynecology, and Reproductive Sciences, Department of Veterans Affairs, University of California, San Francisco, USA.
Obstet Gynecol. 1996 May;87(5 Pt 1):715-21. doi: 10.1016/0029-7844(96)00013-0.
To estimate the prevalence of and identify factors associated with urinary incontinence in older women.
A cross-sectional study involved 7949 community-dwelling women, with a mean (+/- standard deviation) age of 76.9 +/- 5.0 years, recruited from population-based listings to participate in the Study of Osteoporotic Fractures. The prevalence and severity of urinary incontinence during the previous 12 months were assessed by questionnaire. Factors potentially associated with urinary incontinence were assessed by questionnaire, interview, and physical examination. Multivariate logistic regression analysis was used to determine the independent associations between these factors and the primary outcome of daily incontinence.
Forty-one percent (3285) of the women reported urinary incontinence, with 14% (1130) reporting daily incontinence. In multivariate analysis, the prevalence of daily urinary incontinence increased significantly with age (odds ratio [OR] 1.3 per 5 years, 95% confidence interval [CI] 1.2-1.5), prior hysterectomy (OR 1.4, 95% CI 1.1-1.6), higher body mass index (OR 1.6 per 5 units, 95% CI 1.4-1.7), history of stroke (OR 1.9, 95% CI 1.3-2.7), diabetes (OR 1.7, 95% CI 1.2-2.4), chronic obstructive pulmonary disease (OR 1.7, 95% CI 1.1-1.9), and poor overall health (OR 1.6, 95% CI 1.3-2.1). Faster gait speed (OR 0.8 per 0.2 units, 95% CI 0.6-1.0) was associated with decreased incontinence.
Urinary incontinence is a common problem in older women, more common than most chronic medical conditions. Of the associated factors that are preventable or modifiable, obesity and hysterectomy may have the greatest impact on the prevalence of daily incontinence.
评估老年女性尿失禁的患病率，并确定与之相关的因素。
一项横断面研究纳入了7949名社区居住女性，她们的平均（±标准差）年龄为76.9±5.0岁，从基于人群的列表中招募而来，参与骨质疏松性骨折研究。通过问卷调查评估前12个月内尿失禁的患病率和严重程度。通过问卷调查、访谈和体格检查评估可能与尿失禁相关的因素。采用多因素逻辑回归分析来确定这些因素与每日尿失禁这一主要结局之间的独立关联。
41%（3285名）女性报告有尿失禁，其中14%（1130名）报告每日尿失禁。在多因素分析中，每日尿失禁的患病率随年龄显著增加（每5岁优势比[OR]为1.3，95%置信区间[CI]为1.2 - 1.5）、既往子宫切除术（OR为1.4，95% CI为1.1 - 1.6）、较高的体重指数（每5个单位OR为1.6，95% CI为1.4 - 1.7）、中风病史（OR为1.9，95% CI为1.3 - 2.7）、糖尿病（OR为1.7，95% CI为1.2 - 2.4）、慢性阻塞性肺疾病（OR为1.7，95% CI为1.1 - 1.9）以及总体健康状况较差（OR为1.6，95% CI为1.3 - 2.1）而增加。更快的步速（每0.2个单位OR为0.8，95% CI为0.6 - 1.0）与尿失禁减少相关。
尿失禁是老年女性中的常见问题，比大多数慢性疾病更为常见。在可预防或可改变的相关因素中，肥胖和子宫切除术可能对每日尿失禁的患病率影响最大。
