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. 2025 Jun;44(5):1149-1155.
doi: 10.1002/nau.70064. Epub 2025 May 2.

The Relationship Between Urinary Incontinence, Mortality, and Frailty: Insights From a Large Cohort Study

Niharika Malviya  1 , Tracy Cheung  1 , Joseph Kim  2 , Kelli Aibel  2 , Chihiro Okada  1 , Nitya Abraham  1   2
Affiliations

The Relationship Between Urinary Incontinence, Mortality, and Frailty: Insights From a Large Cohort Study

Niharika Malviya et al. Neurourol Urodyn. 2025 Jun.

Abstract

Objective: This study aims to explore the relationship between urinary incontinence (UI) and mortality in women, with a focus on the potential role of frailty and variations across UI subtypes.

Methods: We analyzed 8967 women aged 40 and above who were part of the National Health and Nutrition Examination Survey (NHANES). Kaplan-Meier survival curves and Cox regression analyses were performed to assess the relationship between urge UI (UUI), stress UI (SUI), other UI (OUI) and all-cause mortality. These models were adjusted for demographic variables and frailty scores.

Results: Approximately 45.8% of participants reported UI in the past year. Initial analysis showed a significant association between UI and increased mortality risk (hazard ratio [HR] = 1.478, 95% confidence interval [CI] 1.317-1.657, p < 0.001), persisting after controlling for frailty (HR = 1.151, 95% CI 1.022-1.297, p = 0.021). However, after adjusting for frailty and demographic factors, this association became non-significant.

Conclusion: Women with UI exhibited a significantly increased risk of all-cause mortality, but this association did not hold after accounting for both key demographics and frailty.

Keywords: frailty; mortality; nhanes; stress incontinence; survival analysis; urge incontinence; urinary incontinence.

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