Differences in prevalence of urinary incontinence by race/ethnicity

Abstract

Purpose: We compared the prevalence of urinary incontinence by type among white, black, Hispanic and Asian-American women.

Materials and methods: The RRISK is a population based cohort study of 2,109 randomly selected middle-aged and older women. Incontinence and other variables were assessed by self-report questionnaires and in person interviews. Labor and delivery and surgical data were abstracted from medical records archived since 1946. Logistic regression was used to estimate the OR with 95% CIs for incontinence while adjusting for covariates.

Results: The age adjusted prevalence of weekly incontinence was highest among Hispanic women, followed by white, black and Asian-American women (36%, 30%, 25% and 19%, respectively, p <0.001). Type of incontinence also differed among groups, with weekly stress incontinence prevalence being 18%, 15%, 8% and 8% (p <0.001), and weekly urge incontinence prevalence being 10%, 9%, 14% and 7% (p <0.001). After adjustment for age, parity, hysterectomy, estrogen use, body mass, menopausal status and diabetes, the risk of stress incontinence remained significantly lower in black (adjusted OR 0.36, 95% CI 0.23-0.57) and Asian-American (adjusted OR 0.54, 95% CI 0.34-0.86) women compared to white women. In contrast, the risk of urge incontinence was similar in black (adjusted OR 1.19, 95% CI 0.79-1.81) and Asian-American (adjusted OR 0.86, 95% CI 0.52-1.43) women compared to white women.

Conclusions: Significant differences in the adjusted risk of stress incontinence among Hispanic, white, black and Asian-American women suggest the presence of additional, as yet unrecognized, risk or protective factors for stress incontinence.

Fig 1

Flowchart showing recruitment of subjects for RRISK

Fig 2

Prevalence of weekly urinary incontinence by type in each racial/ethnic group, adjusted for age. Dark blue indicates any incontinence, red stress incontinence and yellow urge incontinence.

Fig. 3

Prevalence of urinary incontinence by frequency in each racial/ethnic group after adjustment for potential effect of response bias. Dark blue indicates any incontinence in last 12 months, red incontinence at least once per month, yellow incontinence at least once per week and light blue daily incontinence.