Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2002 Mar;50(3):489-95.
doi: 10.1046/j.1532-5415.2002.50115.x.

Urinary incontinence and psychological distress in community-dwelling older adults

Hillary R Bogner  1 , Joseph J Gallo, Mary D Sammel, Daniel E Ford, Haroutune K Armenian, William W Eaton
Affiliations

Urinary incontinence and psychological distress in community-dwelling older adults

Hillary R Bogner et al. J Am Geriatr Soc. 2002 Mar.

Abstract

Objectives: To examine the relationship between urinary incontinence (UI) and psychological distress in older adults. We hypothesized that persons with UI associated with condition-specific functional loss would be most likely to report psychological distress.

Design: A population-based longitudinal survey.

Setting: Continuing participants in a study of community-dwelling adults who were initially living in East Baltimore in 1981.

Participants: Persons aged 50 and older (n=781) at follow-up interviews conducted between 1993 and 1996 for whom complete data were available.

Measurements: Participants were classified as incontinent if they reported any uncontrolled urine loss within the 12 months preceding the 13-year follow-up interview. Condition-specific functional loss secondary to UI was further assessed based on a series of questions relating directly to participants' inability to engage in certain activities due to their UI. Psychological distress was assessed using the General Health Questionnaire (GHQ) at interviews in 1981 and at the 13-year follow-up.

Results: Persons with UI were more likely to experience psychological distress as measured by the GHQ than were persons without UI (unadjusted odds ratio (OR)=1.74, 95% confidence interval (CI)=1.13-2.68). Persons with condition-specific functional loss secondary to UI were substantially more likely to have psychological distress as measured by the GHQ than were persons without UI (unadjusted OR=4.02, 95% CI=1.86-8.70). In multivariate models that controlled for potentially influential characteristics such as age, gender, ethnicity, and chronic medical conditions the association between condition-specific functional loss secondary to UI and psychological distress remained statistically significant. Among people with UI, persons with persistently elevated GHQ scores were much more likely to report condition-specific functional impairment from UI (adjusted OR=6.55, 95% CI=1.94-22.12).

Conclusion: Individuals with UI, especially when incontinence was associated with condition-specific functional loss, were more likely to have psychological distress than were other older adults. Our findings support a general conceptual model that condition-specific functional impairment mediates the relationship between a chronic medical condition and psychological distress.

PubMed Disclaimer

Figures

Figure 1
Figure 1
Conceptual model for the hypothesis that functional loss mediates the relationship between urinary incontinence and psychological distress.
See this image and copyright information in PMC

References

    1. Thom D. Variation in estimates of urinary incontinence prevalence in the community: Effects of differences in definition, population characteristics, and study type. J Am Geriatr Soc. 1998;46:473–480. - PubMed
    1. Mohide EA. The prevalence and scope of urinary incontinence. Clin Geriatr Med. 1986;2:639–655. - PubMed
    1. Herzog AR, Diokno AC, Brown MB, et al. Two-year incidence, remission, and change patterns of urinary incontinence in noninstitutionalized older adults. J Gerontol. 1990;45:M67–M74. - PubMed
    1. Ouslander JG, Kane RL, Abrass IB. Urinary incontinence in elderly nursing home patients. JAMA. 1982;248:1194–1198. - PubMed
    1. Bhatia NN, Bergman A, Karram MM. Effects of estrogen on urethral function in women with urinary incontinence. Am J Obstet Gynecol. 1989;160:176–181. - PubMed

Publication types