Association of multimorbidity with higher levels of urinary incontinence: a cross-sectional study of 23 089 individuals aged ≥15 years residing in Spain

Abstract

Background: One can assume a relatively high prevalence of urinary incontinence (UI) in people with multimorbidity. However, literature in this area is scarce. There is a need for further robust research to aid GPs to identify patients at a particular risk for UI, and to initiate the early treatment and multidisciplinary management of this condition.

Aim: To examine the association between multimorbidity and UI in 23 089 individuals aged ≥15 years and residing in Spain.

Design and setting: This study used data from the Spanish National Health Survey 2017, a cross-sectional sample of 23 089 participants aged ≥15 years residing in Spain (54.1% female; mean [standard deviation] age = 53.4 [18.9] years).

Method: UI and 30 other physical and mental chronic conditions were self-reported. Multimorbidity was defined as the presence of ≥2 physical and/or mental chronic conditions (excluding UI). Control variables included sex, age, marital status, education, smoking, and alcohol consumption. Multivariable logistic regression analyses were conducted to assess the association between multimorbidity and UI.

Results: The prevalence of UI was 5.9% in this sample. UI was more frequent in the presence than in the absence of each one of the 30 chronic conditions (P<0.001). The proportion of people with UI was also higher in the multimorbidity than in the no-multimorbidity group (9.8% versus 0.7%, P<0.001). After adjusting for several potential confounders (that is, sex, age, marital status, education, smoking, and alcohol), there was a significant and positive relationship between multimorbidity and UI (odds ratio = 5.02, 95% confidence interval [CI] = 3.89 to 6.59, P<0.001).

Conclusion: In this large sample of Spanish individuals aged ≥15 years, suffering from multimorbidity was associated with a significantly higher level of UI.

Keywords: Spain; cross-sectional studies; logistic models; multimorbidity; urinary incontinence.

Figure 1.

Prevalence of urinary incontinence by chronic condition and multimorbidity.^{a a}Multimorbidity was defined as the presence of two or more chronic conditions. Chronic conditions are listed in Box 1. Urinary incontinence and other chronic conditions except obesity were assessed with questions with ‘yes’ and ‘no’ options. BMI was calculated as weight in kilograms divided by height in meters squared based on self-reported weight and height. Using the standard WHO definition, obesity was defined as BMI ≥30 kg/m², and BMI <30 kg/-m² was considered no obesity. Urinary incontinence was more frequent in the presence than in the absence of each one of the 30 chronic conditions or multimorbidity.P -values were based on χ² tests and were corrected using the Benjamini–Hochberg adjustment method. AllP -values were lower than 0.001 (not displayed in the figure). BMI = body mass index. COPD = chronic obstructive pulmonary disease. WHO = World Health Organization.