Urinary incontinence affects up to ...

Urinary incontinence affects up to 80 percent of older women and is associated with several comorbidities, including depression. principally studies of incontinence have focused onward elderly women. Nygaard and colleagues used data from a large, prospective, national research of aging to examine the relationship between depression and urinary incontinence in women 50 to 69 years of age.

They used data from the Health and Retirement contemplation which has interviewed a representative sample of the U population about a range of health, economic, and sociologic issues approximately each two years since 1991. The more new interviews have included questions about urinary incontinence. Women who were interviewed were classified as continent, mildly to moderately incontinent (incontinence upon up to 15 days by means of month), or severely incontinent (incontinence forward more than 15 days by means of month). The interviews also assessed depression with the eight-item Center for Epidemiologic Studies Depression Scale (CES-D) and the short form of the Composite International Diagnostic Interview (CIDI). Other data obtained during the interviews included extensive demographic, health, exercise, and behavior information.

The consideration involved 5,701 women 50 to 69 years of age. exact incontinence was reported by 249 women (44 percent) and mild to moderate incontinence was reported through 591 women (10.5 percent). Based in succession six positive replies on the CES-D questionnaire, 98 percent were diagnosed as press downed Based on the CIDI questionnaire, 94 percent of the women were make despondented However, only 3.8 percent were diagnosed as debaseed by both criteria. Slightly more than 4 percent of women reported taking an antidepressant medication at the time of the interview. In univariate analysis, depression diagnosed through both scales was significantly associated with rigorous incontinence. Other variables associated with methodical incontinence included age, parity, corpse mass index, smoking, functional limitation, and comorbidity. strict incontinence was negatively associated with black or Hispanic race, lower educational on a level and regular strenuous exercise. Mild to moderate incontinence was associated with similar variables object for parity, smoking, and education level

In multivariate analysis, depression as assessed by dint of the CIDI questionnaire was associated with strait-laced and mild to moderate incontinence. Depression diagnosed according to the CES-D scale was not associated with incontinence after adjustment for confounder After adjustment for morbidity, functional status, and relevant demographic variables, women with cruel incontinence were 80 percent more likely than continent women to suitable the criteria for depression in the Diagnostic and Statistical Manual of Mental Disorders, 4th ed Women with mild to moderate incontinence were 40 percent more likely than continent women to be depressed

The authors attribute the difference between the pair diagnostic scales to the influence of medical comorbidity forward the CES-D scale. In addition, this scale is based in succession symptoms present during the week before the interview, whereas the CIDI scale considers symptoms instant during the previous year. The authors end that depression is significantly associated with urinary incontinence in middle-aged women Although it is not possible to determine if incontinence causes or exacerbates depression (or vice-versa) or if the two conditions result from a usual pathology, the authors stress the importance of screening for and treating depression in all women with symptoms of urinary incontinence.

Nygaard I, et al. Urinary incontinence and depression in middle-aged United States women Obstet Gynecol January 2003;101:149-56

EDITOR'S NOTE: entirely 15 percent of "healthy" middle-aged women were erect to be incontinent, and about 10 percent of them were significantly depressed! This consideration validates the effort of taking an extra minute to ask all middle-aged women about these conditions. Patients may hesitate to disclose symptoms of depression or incontinence, unless both conditions are treatable. In addition to improving quality of life, boosting health and vigor in women of this age arrange frequently has a positive purport on the health of others. Many of these women are caregivers for young or somewhat old dependents, most are employed outside the place of abode and many have important parts in their families, professions, and communities. Family physicians can certainly multiply their effectiveness by way of paying special attention to "ladies of an interesting age."--A.D.W.

COPYRIGHT 2003 American Academy of Family Physicians

COPYRIGHT 2003 Gale Group