Association of chronic conditions and physical multimorbidity with new-onset incontinence in a nationwide prospective cohort study of older adults ≥ 50 years in China

Haibin Li; Xinye Zou; Ruolin Zhang; Siyu Zou; Frank Qian; Jin Zheng; Angela Y Xiao; Xiuhua Guo

doi:10.1093/ageing/afad258

Association of chronic conditions and physical multimorbidity with new-onset incontinence in a nationwide prospective cohort study of older adults ≥ 50 years in China

Age Ageing. 2024 Jan 2;53(1):afad258. doi: 10.1093/ageing/afad258.

Authors

Haibin Li^{1

2}, Xinye Zou³, Ruolin Zhang⁴, Siyu Zou⁵, Frank Qian⁶, Jin Zheng⁷, Angela Y Xiao⁸, Xiuhua Guo^{2

9}

Affiliations

¹ Department of Cardiac Surgery, Heart Center & Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, Capital Medical University, Beijing, China.
² Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University, Beijing, China.
³ Cambridge Institute of Public Health, School of Clinical Medicine, University of Cambridge, Cambridge, UK.
⁴ Department of Natural and Applied Science, Duke Kunshan University, No. 8 Duke Ave., Kunshan, Jiangsu 215316, China.
⁵ Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 N. Wolfe Street, Baltimore, MD 21205, USA.
⁶ Department of Medicine, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA.
⁷ Department of Radiology, University of Cambridge, Cambridge CB2 0QQ, UK.
⁸ Department of International Studies, Macalester College, 1600 Grand Avenue St. Paul, St Paul, MN 55105, USA.
⁹ Department of Epidemiology and Health Statistics, School of Public Health, Capital Medical University, Beijing, China.

PMID: 38251743
PMCID: PMC10801828 (available on 2025-01-20)
DOI: 10.1093/ageing/afad258

Abstract

Background: The relationship between multimorbidity (i.e. ≥ 2 chronic conditions) and incontinence (i.e. urinary and/or faecal incontinence) is underexplored. This study investigated the association between multimorbidity and incident incontinence in Chinese adults aged ≥50 years.

Methods: Data from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study were used. The association between 12 chronic conditions, multimorbidity and new-onset incontinence was analysed using weighted logistic regression models. Mediation analysis was conducted to explore the potential mediators (self-reported health, subjective memory, depressive symptoms, disability, cognitive function, handgrip strength, mobility limitations, medications and frailty status) between multimorbidity and incontinence.

Findings: Among 9,986 individuals aged ≥50 years who were continent at baseline, 5.3% (n = 521) were newly incontinent 4 years later (incident cases). The risk of incident incontinence increased with physical multimorbidity (OR 2.04, 95% CI 1.62-2.57). Compared to no chronic condition, having 1, 2, 3 and ≥ 4 chronic conditions were associated with incident incontinence with OR (95% CI): 1.41 (1.01-1.97), 1.74 (1.24-2.44), 2.82 (1.93-4.12) and 3.99 (2.29-6.95), respectively. The association between multimorbidity and incontinence was mediated by self-reported health (41.2%), medications (26.6%), mobility limitations (20.9%), depressive symptoms (12.8%), disability (11.6%), subjective memory (8.7%) and frailty status (8.3%).

Conclusion: This longitudinal study found that physical multimorbidity and specific chronic conditions may increase the risk of new-onset incontinence among Chinese adults aged ≥50 years. Self-reported health, medications and mobility limitations seemed to be important intermediate conditions between multimorbidity and incident incontinence.

Keywords: incident incontinence; mediation analysis; older people; physical multimorbidity.

MeSH terms

Aged
China / epidemiology
Chronic Disease
Frailty*
Hand Strength
Humans
Longitudinal Studies
Mobility Limitation
Multimorbidity
Prospective Studies

Abstract

MeSH terms

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