Risk Factors for Urinary Incontinence in Women

描述(申请人提供)：大小便失禁是一种常见的情况， 很少有女性与她们的医疗提供者讨论。在这项拨款申请中，我们 建议充分利用现有的两项大型前瞻性研究 37-85岁女性尿失禁流行病学调查 (用户界面)跨不同年龄段。尽管奇偶性是一个公认的预测因子 大小便失禁，有关生殖特征的详细数据很少，而且 关于其他危险因素的大型前瞻性流行病学研究很少见； 特别是，由于生活方式可能会因为大小便失禁而改变，所以 必须识别和确认预期数据中的关联，以便 因果关系没有被挪用。我们计划前瞻性地研究 生殖特征、体重和体力活动的关系， 以及激素因素对尿失禁的发生、不同类型的尿失禁(冲动， 压力，或混合性尿失禁)，其严重性，其进展，以及其 S对女性日常生活的影响。 调查将利用护士的健康学习和护士 健康研究II，对121,701名和116.678名女护士的观察性研究， 分别进行了分析。通过两年一次的邮寄调查问卷收集大量数据 (自1976年NHS和NHSII自1989年以来)关于生活方式和众多 疾病。这包括最新的生殖信息、体重、 运动习惯、更年期、外源性激素使用等许多项目。 有关大小便失禁的详细信息将通过全面的 向所有报告主要泄密情况的妇女发放补充问卷 问卷调查；这将引出有关大小便失禁类型、治疗和 大小便失禁令人烦恼或受限的程度。基于 NHS的初步数据显示，33.8%的大小便失禁患病率类似于 其他组织报告的，四年内3.2%的发病率是 这与现有的少数几项后续研究的结果相当。这些相似之处 表明护士参与者准确地报告了失禁，并且我们的 数据可以推广到其他人群。NHS和NHSII都有 保持极高的参与度(到目前为止在两项研究中都超过909次)。 这两个现有队列提供了一个经济高效的基础来进行 对尿失禁的前瞻性研究，使人们能够更好地了解尿失禁的流行病学 用户界面，以及确定预防策略。此外， 建立这些研究大小便失禁的队列将使未来 对许多其他问题的调查，如饮食的影响和各种 生活习惯。

DESCRIPTION (provided by applicant): Incontinence is a common condition that few women discuss with their medical provider. In this grant application, we propose to capitalize on the availability of two large prospective studies of women aged 37-85 years, to examine the epidemiology of urinary incontinence (UI) across varying age groups. Although parity is an established predictor of incontinence, detailed data on reproductive characteristics are sparse, and large prospective epidemiologic studies on additional risk factors are rare; in particular, since lifestyle may change as a result of incontinence, it is essential to identify and confirm associations in prospective data so that cause and effect are not misappropriated. We plan to examine prospectively the relation of reproductive characteristics, body weight and physical activity, and hormonal factors to the incidence of UI, to different types of UI (urge, stress, or mixed incontinence), to its severity, its progression, and to its impact on women s daily lives. The investigation will utilize the Nurses Health Study and the Nurses Health Study II, observational studies of 121,701 and 116.678 female nurses, respectively. Extensive data are collected via biennial, mailed questionnaires (since 1976 for NHS and since 1989 for NHSII) regarding lifestyle and numerous diseases. This includes updated reproductive information, body weight, exercise habits, menopause, exogenous hormone use, and many other items. Details regarding incontinence will be established via a comprehensive supplementary questionnaire to all women who report leaking on the main questionnaires; this will elicit data on type of incontinence, treatment, and extent to which the incontinence is bothersome or restrictive. Based on preliminary data from NHS, the 33.8% prevalence of incontinence is similar to that reported by other groups, and the 3.2% four-year incidence rate is comparable to that in the few existing follow-up studies. These similarities indicate the nurse participants report incontinence accurately and that our data are generalizable to other populations. Both NHS and NHSII have maintained extremely high participation (over 909~ in both studies to date). These two existing cohorts provide a cost-efficient basis for conducting a prospective study of UI, allowing better understanding of the epidemiology of UI, and identification of preventive strategies. In addition, the establishment of these cohorts for studying incontinence will allow future investigations of many other issues, such as the effect of diet and various lifestyle habits.