title: The severity of urinary incontinence decreases health-related quality of life among community-dwelling elderly.
abstract: BACKGROUND
  Urinary incontinence (UI) is an important geriatric syndrome that has been associated with a wide range of health-related outcomes. However, UI severity has rarely been examined in the context of a comprehensive geriatric assessment. Therefore, the aim of this study is to examine the association between UI severity and health-related quality of life (QoL) when frequent geriatric issues are taken into account.
  
  
  METHODS
  We performed a cross-sectional study of 1,124 participants aged 70 y and older. UI was diagnosed when difficulty with urinary continence was reported, and its severity was assessed through a modified version of the Sandvik Index. Health-related QoL was measured using the SF-36, including its physical and mental component summaries. Multivariate linear regression was performed to determine the association between UI severity and health-related QoL.
  
  
  RESULTS
  Prevalence of UI was 18%, and it was severe in 29.3% of cases. Severely incontinent subjects were older and had worse self-perceived health status, greater disability, and more depressive symptoms in comparison with continent participants or with those affected to a lesser degree. Multivariate regression analysis showed a significant inverse association between the physical component summaries and moderate (B = -4.54) as well as severe UI (B = -6.72). The mental component summaries showed similar results (B = -1.44 and -4.43, respectively).
  
  
  CONCLUSIONS
  UI severity is associated with lower QoL scores in both its components. This association appears to be more important as severity increases. UI severity must be evaluated thoroughly in the elderly because of its potential adverse effects on physical and mental health.
authors.affiliation: Department of Geriatrics Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico.
authors.forename: Sara
authors.initials: S
authors.lastname: Aguilar-Navarro
authors.forename: Ana Patricia
authors.initials: AP
authors.lastname: Navarrete-Reyes
authors.forename: Bernardo Horacio
authors.initials: BH
authors.lastname: Grados-Chavarría
authors.forename: Juan Miguel Antonio
authors.initials: JM
authors.lastname: García-Lara
authors.forename: Hélène
authors.initials: H
authors.lastname: Amieva
authors.forename: José Alberto
authors.initials: JA
authors.lastname: Avila-Funes
mesh_terms: D017677:Age Distribution; D000368:Aged; D000704:Analysis of Variance; D016009:Chi-Square Distribution; D003430:Cross-Sectional Studies; D005260:Female; D016330:Frail Elderly; D015577:Geriatric Assessment / Q000379:methods*; D006801:Humans; D057187:Independent Living; D016014:Linear Models; D008297:Male; D008800:Mexico; D015999:Multivariate Analysis; D015995:Prevalence; D011788:Quality of Life; D012111:Residence Characteristics; D018570:Risk Assessment; D012720:Severity of Illness Index; D017678:Sex Distribution; D012959:Socioeconomic Factors; D014549:Urinary Incontinence / Q000175:diagnosis* / Q000453:epidemiology* / Q000523:psychology; D055815:Young Adult