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Age and Ageing Advance Access originally published online on October 18, 2005
Age and Ageing 2006 35(1):16-24; doi:10.1093/ageing/afi205
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© The Author 2006. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

Urinary storage symptoms and comorbidities: a prospective population cohort study in middle-aged and older women

Catherine W. McGrother, Madeleine M. K. Donaldson, Tom Hayward, Ruth Matthews, Helen M. Dallosso, Colin Hyde The Leicestershire MRC Incontinence Study Team

Department of Epidemiology and Public Health, University of Leicester, 22–28 Princess Road West, Leicester LE1 6TP, UK

Correspondence to: C. W. McGrother. Tel: (+44) 116 252 3197. Fax: (+44) 116 252 5423. Email: cm45{at}le.ac.uk

Objective: to identify predictive morbidities for urinary storage syndromes including indicators for neurological, musculoskeletal, cardiovascular, immune, lower bowel and psychological systems. This is the first study to test prior hypotheses, based on a literature review.

Design: this was a prospective cohort study involving 12,570 female respondents aged 40 or more registered with general practitioners and living at home in Leicestershire. Postal questionnaires were used at baseline and 1-year follow-up (response rates 65 and 79%, respectively).

Measures: pure stress urinary incontinence (SUI) and overactive bladder syndrome (OAB) were defined using standardised symptom indicators. Specific morbidities included reported medical diagnoses, standardised symptoms and general health indicators. Associations were identified using logistic regression, adjusting for age and physical impairment, with separate models for general and specific morbidities.

Results: multivariate morbidities consistently associated (i.e. both longitudinally and cross-sectionally) were SUI—cystitis and obesity; and OAB—bowel urgency, osteoporosis, imbalance, ankle swelling, cystitis, poor health and old age. Other independent predictors were SUI—multiple sclerosis and joint pain; and OAB—deep vein thrombosis and diabetes. Consistent univariate indicators supported neurological, musculoskeletal, cardiovascular, immunological and psychological connections with both types of storage disorder plus an association with lower bowel problems for OAB.

Conclusions: abnormal urinary storage symptoms were predicted by obesity and poor general health, involving a range of systems of the body. OAB showed more extensive links than SUI with specific morbidities, including more medically diagnosed as opposed to symptom-based conditions. These findings were independent of problems with physical impairment.

Keywords: urinary disorders, comorbidities, epidemiology, incontinence, aetiology, elderly

Received August 11, 2003; accepted in revised form August 4, 2005.


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