The epidemiology of urinary incontinence in older women: Incidence, progression, and remission
The epidemiology of urinary incontinence in older women: Incidence, progression, and remission
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DOI：
10.1111/j.1532-5415.2008.01747.x
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发表时间：
2008-07-01
影响因子：
6.3
通讯作者：
Grodstein, Francine
中科院分区：
文献类型：
--
作者：
Lifford, Karen L.;Townsend, Mary K.;Grodstein, Francine
目的：设计：前瞻性研究。背景：护士健康研究。参与者：在23,792名年龄在54岁至79岁的妇女中确定尿失禁（UI）的发病率，基线时无UI。在28，813名患有UI的妇女中，在基线时至少每月确定UI的进展或缓解。计算UI的发生率和流行UI的进展或缓解率。Logistic回归分析用于估计与危险因素相关的UI的相对风险。结果：在基线时无漏尿的女性中，2年后至少每月有9.2%的女性报告漏尿。对于至少每周发生一次渗漏的女性，发生率为3.6%;在这些病例中，压力性UI的发生率最高，其次是混合性和紧迫性UI。UI与年龄之间的关系对于压力UI来说有所不同，随着年龄的增长而下降（相对危险度（RR）=0.63，95%可信区间（CI）=0.43-0.92，年龄70-79岁vs 54-59岁），急迫性和混合性UI，随年龄增加而增加（RR=2.28，95%CI =1.09-4.75; RR=2.11，95%CI =1.24-3.61）。对于2000年的流行UI，32.1%每月发生一次渗漏的受试者在随访期间进展为每周至少发生一次渗漏。只有8.9%的频繁泄漏在2000年报告改善每月泄漏或更少，与2.0%有完全relevance.CONCLUSION：UI的发病率高，在老年妇女，和进展，从偶尔到频繁泄漏是常见的。急迫性尿失禁的有效治疗方法有限，随着年龄的增长而增加，因此对老年妇女尿失禁预防的研究尤为重要。
OBJECTIVES: To examine the epidemiology of urinary incontinence (UI) in older women.DESIGN: Prospective study.SETTING: Nurses' Health Study.PARTICIPANTS: Incidence of UI was determined in 23,792 women aged 54 to 79 without UI at baseline. Progression or remission of UI was determined in 28,813 women with UI at least monthly at baseline.MEASUREMENTS: UI was ascertained according to questionnaires in 2000 and 2002. Rates of incident UI and progression or remission of prevalent UI were calculated. Logistic regression was used to estimate relative risks of UI associated with risk factors.RESULTS: In women with no urine leakage at baseline, 9.2% reported leakage at least monthly after 2 years. For women with leakage at least weekly, the incidence was 3.6%; of these cases, stress UI had the highest incidence, followed by mixed and urge UI. Relationships between UI and age differed for stress UI, which decreased with age (relative risk (RR)=0.63, 95% confidence interval (CI)=0.43-0.92 for aged 70-79 vs 54-59), and urge and mixed UI, which increased with age (RR=2.28, 95% CI=1.09-4.75 and RR=2.11, 95% CI=1.24-3.61, respectively). For prevalent UI in 2000, 32.1% of subjects with leakage once a month progressed to leakage at least once a week over follow-up. Only 8.9% with frequent leakage in 2000 reported improvement to monthly leakage or less, with 2.0% having complete remission.CONCLUSION: The incidence of UI is high in older women, and progression from occasional to frequent leaking is common. Urge UI, for which there are limited effective treatments, increases with age, thus research on UI prevention in older women is particularly important.