Updated Prevalence of Urinary Incontinence in Women: 2015–2018 National Population-Based Survey Data

Abstract

ObjectivesThis study aimed to update estimates of urinary incontinence (UI) prevalence and associated risk factors for adult women in the United States, using the National Health and Nutrition Examination Survey (NHANES).MethodsWe used descriptive analysis of 2015–2018 NHANES weighted data for women to estimate prevalence and characterize UI types and severity. Logistic regression modeling determined adjusted associations with UI.ResultsComplete data were available for 5,006 women. In weighted analyses, 61.8% had UI, corresponding to 78,297,094 adult U.S. women, with 32.4% of all women reporting symptoms at least monthly. Of those with UI, 37.5% had stress urinary incontinence, 22.0% had urgency urinary incontinence, 31.3% had mixed symptoms, and 9.2% had unspecified incontinence. The prevalence of moderate or more severe UI by Sandvik Severity Index was 22.1%, corresponding to 28,454,778 adult U.S. women. In multivariate models, increasing age, body mass index ≥25, prior vaginal birth, anxiety, depression, functional dependence, and non-Hispanic White ethnicity and race were associated with any and moderate UI. Urinary incontinence was not associated with diabetes, education level, prior hysterectomy, smoking status, physical activity level, or current pregnancy status.ConclusionsMore than 60% of community-dwelling adult women in the United States experience any UI and an increase from prior estimates (38%–49%) using NHANES data from 1999 to 2004; more than 20% experience moderate or more severe UI. Increases in UI prevalence may be related to population aging and increasing obesity prevalence. Age greater than 70 years, body mass index >40, and vaginal birth had the strongest association with UI in multivariate modeling.

Adherence to professional society guidelines among women with stress or mixed urinary incontinence

“…Physician specialty at index date was derived from the MarketScan database wherein physicians with an internal medicine or family medicine specialty were categorized as Primary Care Physicians (PCPs) and specialists were defined as physicians with a specialty classification of urology or obstetrics & gynecology using provider type codes that are representative of the provider types based on the Watson Health standards (internal medicine: 204; family medicine: 240; urology: 210; obstetrics & gynecology: 320). Due to the reported association of anxiety and depression with UI, the use of antianxiety and antidepressant medications was assessed by using National Drug Codes (NDCs) in the 2‐year postindex period 1 . Claims for complications after surgeries included in guidelines were identified in the 30 days following the date of surgery.…”

“…1 Severity and prevalence increase with age and prevalence is projected to increase in part due to the large aging demographic and national obesity epidemic, as both are risk factors for UI. 1,2 UI is associated with economic, psychosocial, and physical burdens at the individual-and societal level. [3][4][5] All UI involves the involuntary loss of urine and the predominant subtypes among females are stress urinary incontinence (SUI), urgency urinary incontinence (UUI), and mixed urinary incontinence (MUI), involving involuntary loss of urine on effort, physical exertion, coughing or sneezing, involuntary loss of urine associated with urinary urgency, and involuntary loss of urine with urgency and physical exertion, effort, coughing or sneezing, respectively.…”

Healthcare resource use and cost burden of urinary incontinence to United States payers

“…Additional contributors to risk include smoking, constipation, and genetic factors 3,4 . UI affects over 60% of women in the United States with prevalence estimates varying based upon study population and UI measurement 5,6 …”

“…3,4 UI affects over 60% of women in the United States with prevalence estimates varying based upon study population and UI measurement. 5,6 UI is infrequently addressed during routine healthcare visits despite its high prevalence and associated symptoms, [7][8][9] and adverse impact on health and quality of life. 10,11 As a result, UI can impose a significant burden on patients' health and finances.…”

Sport-related risk factors for moderate or severe urinary incontinence in master female weightlifters: A cross-sectional study

“…Urinary incontinence (UI), defined as the involuntary loss of urine, is common. An analysis of 2015–2018 National Health and Nutrition Examination Survey (NHANES) estimated the prevalence of UI in U.S. women ages 20 and older to be 48.1% overall and 27.8% moderate or more severe [ 1 ]. The prevalence of moderate or more severe UI was lower at younger ages, e.g., 20% at ages 35–39, and higher at older ages, e.g., 40% at ages 70–74 [ 1 ].…”