Investigation of urinary incontinence in Japanese elderly women aged 75 to 90 years

Harai M1, Mori M2

Research Type

Clinical

Abstract Category

Female Lower Urinary Tract Symptoms (LUTS) / Voiding Dysfunction

Abstract 702
Non Discussion Abstracts
Scientific Non Discussion Abstract Session 36
Female Incontinence Voiding Dysfunction
1. School of Nursing, Sapporo City University, 2. Hokkaido Chitose College of Rehabilitation
Links

Abstract

Hypothesis / aims of study
In women, urinary incontinence (UI), childbirth, and obesity have been studied extensively. In addition, the prevalence and risk factors of UI among women of various ages have been evaluated. However, no study has elucidated the change in rate of UI complaints according to the age of women living in the same area. We studied the rate of UI complaints among older women in a previous study. In this study, we investigated the rate of UI complaints in very elderly women residing in the same area and examined the change in status of self-reported prevalence rates with aging.
The purpose of this study is to clarify the rate of self-reported prevalence of UI and its frequency among Japanese elderly women aged 75–90 years.
Study design, materials and methods
This study was conducted in August 2017. The subjects were 400 women aged 75–90 years, residing in the northern cities of Japan. The survey was conducted using self-administered questionnaire sent by mail. The population of women aged 75–89 years in this city was 126,327, and the study subjects were 0.003% of this population [1]. UI was defined as involuntary urination that occurred at least once a week. The questionnaire contains items targeting 29 factors, including fundamental attributes, health condition, lifestyle habits, medical history, state of UI, and the International Consultation on Incontinence Questionnaire-Short Form [2]. This study was approved by the ethical committee of own University and was approved by the ethical committee of own University  and was funded by the ethical committee of own University.
Results
Among those who received the self-reported questionnaire, 103 women (response rate, 25.8%) returned the completed questionnaire with written informed consent.
The mean age was 81.0 ± 4.1 years. The prevalence of self-reported UI was 45.6%, 36.0% in elderly aged 75–80.5 and 61.7% in those aged 80.6–89.0 years (Figure1). Hence, a significant difference was found in the self-reported prevalence rate of UI with aging (p = 0.015, chi-square test).
The frequency of incontinence was reported as “approximately once a week or less” by 19 respondents (19.4%), “2–3 times a week” by 7 respondents (7.1%), “approximately once a day” by 8 respondents (8.2%), “several times a day” by 10 respondents (10.2%), and “always” by 3 respondents (3.1%) (Figure2). Changes in the state of UI over the past year was reported as “decrease” by two respondents (1.9%) and “increase” by 10 respondents (9.7%).
In the elderly women, UI was noted at the following times (multiple responses): before going to the toilet (n = 20 [19.4%]), during coughing or sneezing (32 [31.1%]), during sleep (6 [5.8%]), while moving or exercising (3 [2.9%]), unknown (2 [1.9%]), and continuous presence (3 [2.9%]).
Interpretation of results
The prevalence of self-reported UI was 45.6%. Particularly, the prevalence rate in elderly aged 75–80.5 was 36.0% and in those aged 80.6–89.0 years was 61.7%. Our previous study (2013) [3] found that the prevalence rate of UI was 29.7% in Japanese elderly women aged 65–80 years. Furthermore, there was a significant difference between the self-reported prevalence rate among elderly aged 75–80.5 and 80.6–89.0 years (p = 0.015, chi-square test). Therefore, the self-reported prevalence rate of UI in elderly Japanese women seemed to increase with aging.
UI was reported to occur at least once a week, less often, or every time in this age group. Moreover, 10 respondents (9.7%) reported that the changes in the state of UI over the past year have increased. Therefore, one year of aging for women of this age group was suggested to have the risk of new onset of UI.
Urgency or functional UI may be experienced before going to the toilet. Moreover, UI may be caused by coughing, sneezing, body movement, and exercise.  In this study, few women were not aware of the causes of their UI and some women continuously experienced UI, suggesting a characteristic situation in very elderly women.
Concluding message
UI occurred at least once a week, less often, or every time. Moreover, one year of aging for women of this age group was suggested to increase the risk of new onset of UI. We will conduct an analysis to further clarify the risk factors of UI in old-old women.
Figure 1
Figure 2
References
  1. City of Sapporo. http://www.city.sapporo.jp/toukei/jinko/juuki/juuki.html#ku, 2018.3.21
  2. Gotoh M, Donovan J, Corcos J, et al. Scored ICIQ-SF (International consultation on Incontinence Questionnaire Short-Form) for symptoms and QOL assessment in patients with urinary incontinence. J Neurogenic Bladder Soc 2003; 14: 248-55 (Japanese text with English abstract).
  3. Mika Harai, Asae Oura, Yoko Yoshikawa, and Mitsuru Mori. A cross-sectional study to assess weight and other factors associated with the urinary incontinence of elderly women. Jpn J Public Health 60 (2) 2013; 79-86.
Disclosures
Funding This study was funded by a Grants-in-Aid for Scientific Research (2017–2019) in Japan. Clinical Trial No Subjects Human Ethics Committee The ethics Committee of Sapporo City University Helsinki Yes Informed Consent Yes
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