Urinary Incontinence in Older Women: The Role of Body Composition and Muscle Strength: From the Health, Aging, and Body Composition Study.

Anne M Suskind, Peggy M Cawthon, Sanae Nakagawa, Leslee L Subak, Ilse Reinders, Suzanne Satterfield, Steve Cummings, Jane A Cauley, Tamara Harris, Alison J Huang

Journal: Journal of the American Geriatrics Society 2017;65(1):42-50

PMID: 27918084

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Abstract

OBJECTIVES

To evaluate prospective relationships between body composition and muscle strength with predominantly stress urinary incontinence (SUI) and urgency urinary incontinence (UUI) in older women.

DESIGN

Prospective community-dwelling observational cohort study (Health, Aging, and Body Composition study).

PARTICIPANTS

Women initially aged 70 to 79 recruited from Pittsburgh, Pennsylvania, and Memphis, Tennessee (N = 1,475).

MEASUREMENTS

Urinary incontinence was assessed using structured questionnaires. Body mass index (BMI), grip strength, quadriceps torque, and walking speed were assessed using physical examination and performance testing. Appendicular lean body mass (ALM) and whole-body fat mass were measured using dual-energy X-ray absorptiometry.

RESULTS

At baseline, 212 (14%) women reported at least monthly predominantly SUI and 233 (16%) at least monthly predominantly UUI. At 3 years, of 1,137 women, 164 (14%) had new or persistent SUI, and 320 (28%) had new or persistent UUI. Women had greater odds of new or persistent SUI if they demonstrated a 5% or greater decrease in grip strength, (adjusted odds ratio (AOR) = 1.60, P = .047) and lower odds of new or persistent SUI if they demonstrated a 5% or greater decrease in BMI (AOR = 0.46, P = .01), a 5% or greater increase in ALM corrected for BMI (AOR = 0.17, P = .004), or a 5% or greater decrease in fat mass (AOR = 0.53, P = .01). Only a 5% or greater increase in walking speed was associated with new or persistent UUI over 3 years (AOR = 1.54, P = .04).

CONCLUSION

In women aged 70 and older, changes in body composition and grip strength were associated with changes in SUI frequency over time. In contrast, changes in these factors did not influence UUI. Findings suggest that optimization of body composition and muscle strength is more likely to modify risk of SUI than of UUI in older women.

Address: Department of Urology, University of California, San Francisco, California.; California Pacific Medical Center Research Institute, San Francisco, California.; Department of Obstetrics, Gynecology and Reproductive Sciences, University of California, San Francisco, California.; Department of Epidemiology and Biostatistics, University of California, San Francisco, California.; Laboratory of Epidemiology and Population Science, National Institute on Aging, Bethesda, Maryland.; Department of Nutrition and Dietetics, Internal Medicine, VU University Medical Center, Amsterdam, the Netherlands.; Department of Preventive Medicine, Health Science Center, University of Tennessee, Memphis, Tennessee.; Department of Medicine, University of California, San Francisco, California.; Department of Epidemiology, Graduate School for Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania.

DOI: 10.1111/jgs.14545

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MeSH Terms: Absorptiometry, Photon, Aged, Body Composition, Body Mass Index, Cohort Studies, Female, Hand Strength, Humans, Pennsylvania, Tennessee, Urinary Incontinence, Stress, Urinary Incontinence, Urge, Walking Speed