The effect of medication use on urinary incontinence in community-dwelling elderly women.
OBJECTIVE
To evaluate whether use of certain medications with potential urological effects is associated with development of incident urinary incontinence in community-resident older women.


METHODS
Longitudinal cohort study.


METHODS
Pittsburgh, PA, and Memphis, TN.


METHODS
Nine hundred fifty-nine healthy black and white women aged 65 and older enrolled in the Health, Aging and Body Composition Study without baseline (Year 1) self-reported urinary incontinence.


METHODS
Use of alpha blockers, anticholinergics, central nervous system medications (opioids, benzodiazepines, antidepressants, antipsychotics), diuretics (thiazide, loop, potassium sparing), and estrogen (all dosage forms) was determined during Year 3 interviews. Self-reported incident (≥ weekly) incontinence in during the previous 12 months was assessed at Year 4 interviews.


RESULTS
Overall, 20.5% of these women reported incident incontinence at Year 4 (3 years from baseline). The most common medication used with potential urological activity was a thiazide diuretic (24.3%), followed by estrogen (22.2%); alpha blockers were the least commonly used (2.3%). Multivariable logistic regression analyses revealed that current users of alpha blockers (adjusted odds ratio (AOR)=4.98, 95% confidence interval (CI)=1.96-12.64) and estrogen (AOR=1.60, 95% CI=1.08-2.36) had a greater risk of urinary incontinence than nonusers. There was no greater risk (P>.05) of urinary incontinence with the current use of anticholinergics, central nervous system medications, or diuretics. No statistically significant race-by-medication use interactions were found (all P>.05).


CONCLUSIONS
These results corroborate earlier reports that, in elderly women, use of alpha blockers or estrogens is associated with risk of self-reported incident urinary incontinence.
Ruby
Christine M
CM
Department of Pharmacy and Therapeutics, Graduate School of Public Health, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Hanlon
Joseph T
JT
Boudreau
Robert M
RM
Newman
Anne B
AB
Simonsick
Eleanor M
EM
Shorr
Ronald I
RI
Bauer
Douglas C
DC
Resnick
Neil M
NM
D000368:Aged; D002317:Cardiovascular Agents / Q000009:adverse effects*; D002318:Cardiovascular Diseases / Q000188:drug therapy*; D002491:Central Nervous System Agents / Q000009:adverse effects*; D002493:Central Nervous System Diseases / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D011795:Surveys and Questionnaires; D013997:Time Factors; D014481:United States / Q000453:epidemiology; D014549:Urinary Incontinence / Q000139:chemically induced / Q000453:epidemiology* / Q000503:physiopathology; D014563:Urodynamics / Q000187:drug effects*
D002317:Cardiovascular Agents; D002491:Central Nervous System Agents