title: Incidence and remission of urinary incontinence at midlife: a cohort study.
abstract: OBJECTIVE
  Urinary incontinence (UI) is often considered to be an age-related disease that develops gradually as women grow older. Much remains to be learnt about factors that promote its incidence or its remission. Our objective was to assess its incidence and risk factors.
  
  
  METHODS
  Longitudinal cohort study.
  
  
  METHODS
  French GAZEL cohort.
  
  
  METHODS
  A cohort of 4127 middle-aged women (aged 47-52 years at baseline) over an 18-year period (1990-2008).
  
  
  METHODS
  UI was defined as 'difficulty retaining urine'. The question was asked at baseline and repeated every 3 years over an 18-year period. Two groups (UI incidence and remission) were analysed according to status at baseline (continent or incontinent). A multivariable analysis (Cox model) was used to estimate the risk factors for UI incidence and remission.
  
  
  METHODS
  Annual incidence and remission rates and risk factors for UI incidence and remission.
  
  
  RESULTS
  The annual incidence and remission rates for UI were 3.3% and 6.2%, respectively. High educational level (hazard ratio [HR] = 1.28; 95% confidence interval [95% CI] = 1.05-1.55), parity, i.e. at least one baby versus no baby (HR = 1.64; 95% CI = 1.19-2.27), menopause (HR = 5.44; 95% CI = 4.47-6.63), weight gain, i.e. for each kilogram change in weight (HR = 1.00; 95% CI = 1.00-1.02), onset of depressive symptoms (HR = 1.31; 95% CI = 1.09-1.57) and impairment in health-related quality of life incidence (social isolation dimension [HR = 1.29; 95% CI = 1.04-1.60] and energy dimension [HR = 1.41; 95% CI = 1.17-1.70]) were associated with an increased probability of UI. The factors associated with persistent UI were age (HR = 0.58; 95% CI = 0.55-0.61), weight gain (HR = 0.99; 95% CI = 0.98-0.99) and transition to menopausal status (HR = 1.54; 95% CI = 1.19-1.99).
  
  
  CONCLUSIONS
  Our study suggests that, in our population of middle-aged women, age, menopause, weight gain, onset of depression and impaired health-related quality of life may promote UI.
authors: CESP-INSERM, U1018, Equipe 7, Genre, Santé Sexuelle et Reproductive, Université Paris Sud, Le Kremlin-Bicêtre Cedex, France.|Service de Gynécologie-Obstétrique, Assistance Publique-Hôpitaux de Paris, Hôpital de Bicêtre, Le Kremlin Bicêtre Cedex, France.|Service de Gynécologie-Obstétrique, Centre Hospitalier Universitaire d'Angers, Angers Cedex, France.
authors: G
authors: G
authors: Legendre
authors: CESP-INSERM, U1018, Equipe 7, Genre, Santé Sexuelle et Reproductive, Université Paris Sud, Le Kremlin-Bicêtre Cedex, France.
authors: V
authors: V
authors: Ringa
authors: CESP-INSERM, U1018, Equipe 7, Genre, Santé Sexuelle et Reproductive, Université Paris Sud, Le Kremlin-Bicêtre Cedex, France.
authors: H
authors: H
authors: Panjo
authors: CESP-INSERM, U1018, Plate-forme de recherche 'Cohortes en Population', Hôpital Paul Brousse, Villejuif Cedex, France.
authors: M
authors: M
authors: Zins
authors: CESP-INSERM, U1018, Equipe 7, Genre, Santé Sexuelle et Reproductive, Université Paris Sud, Le Kremlin-Bicêtre Cedex, France.|INSERM CIC-P 802, Centre Hospitalier Universitaire de Poitiers, Université de Poitiers, Poitiers, France.|INSERM, UMR S953, Villejuif, France.
authors: X
authors: X
authors: Fritel
mesh_terms: D000367:Age Factors; D005260:Female; D005602:France / Q000453:epidemiology; D006306:Health Surveys; D006801:Humans; D015994:Incidence; D008137:Longitudinal Studies; D008875:Middle Aged; D016016:Proportional Hazards Models; D012075:Remission, Spontaneous; D012307:Risk Factors; D014549:Urinary Incontinence / Q000453:epidemiology* / Q000209:etiology
keywords: Incidence; remission; urinary incontinence