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Age and Ageing Advance Access published online on October 18, 2005
Age and Ageing, doi:10.1093/ageing/afi205
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© The Author 2005. Published by Oxford University Press on behalf of the British Geriatrics Society. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org
Received August 11, 2003
Accepted August 4, 2005

Article

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

Catherine W. McGrother 1*, Madeleine M. K. Donaldson 1, Tom Hayward 1, Ruth Matthews 1, Helen M. Dallosso 1, Colin Hyde 1, and The Leicestershire MRC Incontinence Study Team

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

* To whom correspondence should be addressed.
Catherine W. McGrother, E-mail: cm45{at}le.ac.uk


  Abstract

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 standardized 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.
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