title: Quality-of-life impact and treatment of urinary incontinence in ethnically diverse older women.
abstract: OBJECTIVE
  To identify the factors associated with greater quality-of-life impact, treatment seeking, and use of treatments for urinary incontinence in ethnically diverse older women.
  
  
  METHODS
  Cross-sectional analysis of a population-based cohort of 2109 middle-aged and older women who were randomly selected from age and race/ethnicity strata. Data were collected by self-report questionnaires and in-person interviews. Multivariable logistic regression was used to identify predictors of high quality-of-life impact (Incontinence Impact Questionnaire [IIQ] score > or =75th percentile), treatment seeking, and use of treatments for incontinence.
  
  
  RESULTS
  More than one fourth (n = 603) of the study participants (including 96 black [16%], 123 Latina [20%], 65 Asian [11%], and 309 white [51%] women) reported weekly incontinence. After clinical severity and other factors were adjusted for, women were more likely to experience high quality-of-life impact if they had nighttime incontinence (odds ratio [OR], 2.5; 95% confidence interval [CI], 1.3-4.9), coital incontinence (OR, 1.9; 95% CI, 1.1-3.3), or comorbid fecal incontinence (OR, 2.2; 95% CI, 1.2-4.2). Predictors of treatment seeking included older age (OR, 1.6 per 10 years; 95% CI, 1.2-2.0); higher IIQ score (OR, 4.6 for highest IIQ quartile vs lowest IIQ quartile; 95% CI, 2.5-8.4), and higher household income (OR, 2.6 for income > or = US dollars 100 000/y vs < US dollars 20 000/y; 95% CI, 1.0-2.7).
  
  
  CONCLUSIONS
  Clinicians seeking to evaluate the impact of incontinence on women's lives should assess not only the clinical severity of their symptoms but also the specific context in which symptoms occur. The prevalence of treatment seeking for incontinence is low across all ethnic groups, even when women have clinically severe symptoms and access to a health provider.
authors.affiliation: General Internal Medicine Section, Veterans Affairs Medical Center, San Francisco, CA 94121, USA. ajhuan@yahoo.com
authors.forename: Alison J
authors.initials: AJ
authors.lastname: Huang
authors.forename: Jeanette S
authors.initials: JS
authors.lastname: Brown
authors.forename: Alka M
authors.initials: AM
authors.lastname: Kanaya
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Creasman
authors.forename: Arona I
authors.initials: AI
authors.lastname: Ragins
authors.forename: Stephen K
authors.initials: SK
authors.lastname: Van Den Eeden
authors.forename: David H
authors.initials: DH
authors.lastname: Thom
mesh_terms: D000223:Adaptation, Psychological; D001521:Behavior Therapy / Q000706:statistics & numerical data; D002140:California; D015331:Cohort Studies; D003075:Coitus; D003430:Cross-Sectional Studies; D041382:Diapers, Adult / Q000706:statistics & numerical data; D004522:Educational Status; D005081:Exercise Therapy / Q000706:statistics & numerical data; D005242:Fecal Incontinence / Q000150:complications / Q000523:psychology; D005260:Female; D015438:Health Behavior; D006304:Health Status; D006801:Humans; D016496:Incontinence Pads / Q000706:statistics & numerical data; D007407:Interviews as Topic; D008875:Middle Aged; D015999:Multivariate Analysis; D018727:Muscarinic Antagonists / Q000627:therapeutic use; D010342:Patient Acceptance of Health Care; D017773:Pelvic Floor; D011788:Quality of Life; D044469:Racial Groups; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014549:Urinary Incontinence / Q000150:complications / Q000523:psychology* / Q000628:therapy*
chemical_list: D018727:Muscarinic Antagonists