title: Severity, not type, is the main predictor of decreased quality of life in elderly women with urinary incontinence: a population-based study as part of a randomized controlled trial in primary care.
abstract: BACKGROUND
  Urinary incontinence negatively influences the lives of 25-50% of elderly women, mostly due to feelings of shame and being limited in activities and social interactions. This study explores whether differences exist between types of urinary incontinence (stress, urgency or mixed) and severity of the symptoms, with regard to their effects on generic and condition-specific quality of life.
  
  
  METHODS
  This is a cross-sectional study among participants of a randomized controlled trial in primary care. A total of 225 women (aged ≥ 55 years) completed a questionnaire (on physical/emotional impact and limitations) and were interviewed for demographic characteristics and co-morbidity. Least squares regression analyses were conducted to estimate differences between types and severity of urinary incontinence with regard to their effect on quality of life.
  
  
  RESULTS
  Most patients reported mixed urinary incontinence (50.7%) and a moderate severity of symptoms (48.9%). Stress urinary incontinence had a lower impact on the emotional domain of condition-specific quality of life compared with mixed urinary incontinence (r = -7.81). There were no significant associations between the types of urinary incontinence and generic quality of life. Severe symptoms affected both the generic (r = -0.10) and condition-specific (r = 17.17) quality of life.
  
  
  CONCLUSIONS
  The effects on condition-specific quality of life domains differ slightly between the types of incontinence. The level of severity affects both generic and condition-specific quality of life, indicating that it is not the type but rather the severity of urinary incontinence that is the main predictor of decreased quality of life.
authors.affiliation: Department of General Practice, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands.
authors.forename: Janka A
authors.initials: JA
authors.lastname: Barentsen
authors.forename: Els
authors.initials: E
authors.lastname: Visser
authors.forename: Hedwig
authors.initials: H
authors.lastname: Hofstetter
authors.forename: Anna M
authors.initials: AM
authors.lastname: Maris
authors.forename: Janny H
authors.initials: JH
authors.lastname: Dekker
authors.forename: Geertruida H
authors.initials: GH
authors.lastname: de Bock
mesh_terms: D000368:Aged; D003430:Cross-Sectional Studies; D005260:Female; D005544:Forecasting; D006801:Humans; D016018:Least-Squares Analysis; D008875:Middle Aged; D011320:Primary Health Care; D011788:Quality of Life / Q000523:psychology*; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D014550:Urinary Incontinence, Stress / Q000503:physiopathology / Q000523:psychology*; D053202:Urinary Incontinence, Urge / Q000503:physiopathology / Q000523:psychology*