Nygaard I E, Lemke J H
Department of Preventive Medicine and Environmental Health, University of Iowa College of Medicine, Iowa City, USA.
J Am Geriatr Soc. 1996 Sep;44(9):1049-54. doi: 10.1111/j.1532-5415.1996.tb02936.x.
To determine the prevalence, incidence, and remission rates of urinary incontinence in a large group of older women over a 6-year time span and to assess factors associated with incontinence incidence and remission.
Longitudinal cohort study.
Two rural counties in Iowa.
2025 women aged 65 years or older residing in rural Iowa, enrolled in the Iowa 65+ Rural Health Study of EPESE (Establishment of Populations for Epidemiologic Studies of the Elderly) were interviewed in person annually for 6 years; specific responses to queries about urinary incontinence were given at baseline, 3-, and 6-year intervals.
Conditional multivariate logistic regression analysis was done to assess the relationship between incontinence symptoms and various factors previously found to be related to incontinence.
The baseline prevalence of urge incontinence was 36.3%, and of stress incontinence it was 40.3%. For urge incontinence, the 3-year incidence and remission rates between the third and sixth years were 28.5% and 22.1%, respectively. For stress incontinence, the 3-year incidence and remission rates between years 3 and 6 were 28.6% and 25.1%, respectively. Seventy-six percent and 84% of women who reported no urge or stress incontinence, respectively, at the baseline interview were continent at both follow-up interviews. The only significant factors related to changes in incontinence status were age, which was associated with an increased incidence of urge incontinence (OR 1.11, P = .017, 95% CI 1.019-1.203), and improvement in activities of daily living, which was associated with a increased remission of urge incontinence (OR 0.50, P = .015, 95% CI 0.28-0.9)
In some older women, urinary incontinence is a dynamic state, with women moving back and forth along a continuum between continence and incontinence. These results are tempered by limitations of the study, which include its questionnaire design and lack of ability to detect potential treatment effect.
确定一大群老年女性在6年时间跨度内尿失禁的患病率、发病率和缓解率，并评估与尿失禁发病率和缓解相关的因素。
纵向队列研究。
爱荷华州的两个农村县。
居住在爱荷华州农村的2025名65岁及以上的女性，她们参与了爱荷华州65岁以上农村健康研究（老年人流行病学研究人群的建立），并在6年中每年接受一次面对面访谈；在基线、第3年和第6年间隔时对有关尿失禁的询问给出具体答复。
进行条件多变量逻辑回归分析，以评估尿失禁症状与先前发现与尿失禁相关的各种因素之间的关系。
急迫性尿失禁的基线患病率为36.3%，压力性尿失禁的基线患病率为40.3%。对于急迫性尿失禁，第3年至第6年的3年发病率和缓解率分别为28.5%和22.1%。对于压力性尿失禁，第3年至第6年的3年发病率和缓解率分别为28.6%和25.1%。在基线访谈中报告无急迫性或压力性尿失禁的女性中，分别有76%和84%在两次随访访谈中均无尿失禁。与尿失禁状态变化相关的唯一显著因素是年龄，年龄与急迫性尿失禁发病率增加相关（比值比1.11，P = 0.017，95%可信区间1.019 - 1.203），以及日常生活活动的改善，这与急迫性尿失禁缓解增加相关（比值比0.50，P = 0.015，95%可信区间0.28 - 0.9）。
在一些老年女性中，尿失禁是一种动态状态，女性在尿失禁和非尿失禁之间的连续体上来回变化。这些结果受到研究局限性的影响，包括其问卷设计以及缺乏检测潜在治疗效果的能力。
