Prevalence and Risk Factors of Urinary Incontinence among Elderly Women Residing in Kochi Corporation: A Community-based Cross-sectional Study
Authors: Mainu T. T Carmel Regeela , George Sobha , Raj Arun , Rajiv Midhun 
Published: July 2023

ABSTRACT

Background:
A study was done on the prevalence, risk factors, and treatment-seeking behavior of elderly women with urinary incontinence (UI) residing in Kochi Corporation, Kerala, India. The community-based cross-sectional study was done in Kochi on 525 elderly women aged 60 years and above, selected by cluster random sampling, after getting consent, using a questionnaire. The overall prevalence of UI was found to be 64% (95% confidence interval (CI) 59.5–67.6). The most common type of UI was found to be the urge type of incontinence (38.3%, 95% CI, 34.14–42.45). Chronic cough (odds ratio [OR] 1.754, 95% 1.170–2.631), chronic constipation (OR: 1.563, 95% CI: 1.030–2.373), obesity (OR: 1.591, 95% CI: 1.110–2.280), diabetes (OR: 1.517, 95% CI: 1.036–2.222), and taking medications for diabetes and hypertension (OR: 1.476, 95% 1.008–2.163) were found to be risk factors of UI. Multiparity (OR: 1.757, 95% CI: 1.073–2.876), delivery at home (OR: 1.761, 95% CI: 1.205–2.575), undergoing any pelvic surgery (OR: 1.504, 95% CI: 1.052–2.150) were the gynecological and obstetric factors associated with UI.

Context:
Very few community-based studies are available on UI among elderly women.

Aim:
The primary objective of the study was to estimate the prevalence of UI among elderly women residing in the Kochi corporation. The secondary objective was to determine the risk factors of UI.

Settings and Design:
A community-based cross-sectional study was done in the Kochi Corporation of Ernakulam district.

Subjects and Methods:
A pilot study was conducted and based on this, the sample size was computed to be 72.41. Data from 525 individuals were collected using cluster random sampling. A questionnaire for urinary incontinence diagnosis questionnaire was used for assessing the type of UI.

Statistical Analysis Used:
Percentage prevalence, Chi-square test.

Results:
The overall prevalence of UI was found to be 64%. The most common type of UI was found to be the urge type of incontinence. Chronic cough, chronic constipation, obesity, diabetes, taking medications for diabetes, and hypertension were found to be risk factors of UI. Multiparity, delivery at home, and undergoing any pelvic surgery were the gynecological and obstetric factors associated with UI.

Conclusions:
The prevalence of UI among elderly women in this study was found to be 63.9%. The most common type of UI was found to be urge type of incontinence 38.3%, followed by mixed incontinence 32.3%, and stress incontinence 29.3%. Chronic cough (OR: 1.754), chronic constipation (OR: 1.563), obesity (OR: 1.591), diabetes (OR: 1.517), and taking medications for diabetes and hypertension (OR: 1.476) were found to be risk factors for UI. Multiparity (OR: 1.757), delivery at home (OR: 1.761) and undergoing any pelvic surgery (OR: 1.504) were the gynecological and obstetric factors associated with UI among elderly women in this study. Chronic cough (adjusted odds ratio [aOR] 1.64, 95% CI: 1.08–2.50), obesity (aOR: 1.64, 95% CI: 1.13–2.39), pelvic surgery (aOR: 1.64, 95% CI: 1.13–2.39), and delivery at home (aOR: 1.89, 95% CI: 1.27–2.82) were found to be independent risk factors for UI among elderly women.