title: Urinary incontinence in rural older women: prevalence, incidence and remission.
abstract: OBJECTIVE
  To determine the prevalence, incidence, and remission rates of urinary incontinence in a large group of older women over a 6-year time span and to assess factors associated with incontinence incidence and remission.
  
  
  METHODS
  Longitudinal cohort study.
  
  
  METHODS
  Two rural counties in Iowa.
  
  
  METHODS
  2025 women aged 65 years or older residing in rural Iowa, enrolled in the Iowa 65+ Rural Health Study of EPESE (Establishment of Populations for Epidemiologic Studies of the Elderly) were interviewed in person annually for 6 years; specific responses to queries about urinary incontinence were given at baseline, 3-, and 6-year intervals.
  
  
  METHODS
  Conditional multivariate logistic regression analysis was done to assess the relationship between incontinence symptoms and various factors previously found to be related to incontinence.
  
  
  RESULTS
  The baseline prevalence of urge incontinence was 36.3%, and of stress incontinence it was 40.3%. For urge incontinence, the 3-year incidence and remission rates between the third and sixth years were 28.5% and 22.1%, respectively. For stress incontinence, the 3-year incidence and remission rates between years 3 and 6 were 28.6% and 25.1%, respectively. Seventy-six percent and 84% of women who reported no urge or stress incontinence, respectively, at the baseline interview were continent at both follow-up interviews. The only significant factors related to changes in incontinence status were age, which was associated with an increased incidence of urge incontinence (OR 1.11, P = .017, 95% CI 1.019-1.203), and improvement in activities of daily living, which was associated with a increased remission of urge incontinence (OR 0.50, P = .015, 95% CI 0.28-0.9)
  
  
  CONCLUSIONS
  In some older women, urinary incontinence is a dynamic state, with women moving back and forth along a continuum between continence and incontinence. These results are tempered by limitations of the study, which include its questionnaire design and lack of ability to detect potential treatment effect.
authors.affiliation: Department of Preventive Medicine and Environmental Health, University of Iowa College of Medicine, Iowa City, USA.
authors.forename: I E
authors.initials: IE
authors.lastname: Nygaard
authors.forename: J H
authors.initials: JH
authors.lastname: Lemke
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D006801:Humans; D015994:Incidence; D007484:Iowa / Q000453:epidemiology; D016015:Logistic Models; D008137:Longitudinal Studies; D016017:Odds Ratio; D011159:Population Surveillance; D015995:Prevalence; D012075:Remission, Spontaneous; D012307:Risk Factors; D012423:Rural Health; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000209:etiology