Urinary incontinence and prevalence of high depressive symptoms in older black versus white women

Abstract

Introduction and Hypothesis Previous studies have reported higher prevalence of depression among women with urgency or mixed urinary incontinence (UI) than stress UI. Urgency UI is the dominant UI type among black women, while stress UI is the predominant type among white women. Thus, UI-related mental health issues could be a key consideration among black women. We hypothesized that the association between UI and depression might be stronger in black versus white women. Methods These cross-sectional analyses included 934 black and 71,161 white women aged 58-83 in the Nurses’ Health Study, which was established among women living in the USA. Depressive symptoms were assessed using the ten-item Center for Epidemiologic Studies Depression scale (CESD-10). Multivariable-adjusted odds ratios (ORs) and 95% confidence intervals (CIs) for high depressive symptoms (CESD-10 score≥10) according to self-reported UI frequency, severity, and type were calculated using logistic regression models. Results Although point estimates for associations of UI frequency, severity, and type with high depressive symptoms were higher in black women, differences in ORs between black and white women were not statistically significant. For example, the OR for at least weekly UI compared with no UI was 2.29 (95% CI 1.30-4.01) in black women and 1.58 (95% CI 1.49-1.68) in white women (p-interaction=0.4). Conclusions We did not find statistically significant differences in associations of UI frequency, severity, and type with high depressive symptoms between black and white women. However, small numbers of black women with high depressive symptoms limited statistical power to detect significant interactions. Thus, these results should be interpreted with caution.

Anxiety and depression associated with urinary incontinence. A 10‐year follow‐up study from the Norwegian HUNT study (EPINCONT)

“…The association has been shown to be strongest for urgency and mixed incontinence and for severe incontinence. [1][2][3][4][5][6][7] An association between anxiety and UI has also been found. 5,8,9 Anxiety, depression and UI are all common health problems, and a possible link between them is of great interest.…”

“…Several epidemiologic cross‐sectional studies have linked depression to urinary incontinence (UI) in women. The association has been shown to be strongest for urgency and mixed incontinence and for severe incontinence . An association between anxiety and UI has also been found .…”

Effect of surface electrical stimulation in a seated position on pelvic floor muscle functions, urinary leakage, and quality of life in women with stress urinary incontinence

“…More than 30% of women develop SUI within 5 years after their first vaginal delivery [2]. Although SUI impacts quality of life (QOL), leading not only to physical limitations but also to psychosocial problems, patients often underreport SUI [3]. For mild to moderate SUI, all guidelines recommend noninvasive or conservative treatment before invasive treatment, because this can lead to better outcomes [3].…”

“…Although SUI impacts quality of life (QOL), leading not only to physical limitations but also to psychosocial problems, patients often underreport SUI [3]. For mild to moderate SUI, all guidelines recommend noninvasive or conservative treatment before invasive treatment, because this can lead to better outcomes [3]. Noninvasive treatments include physical and behavioral therapy, such as bladder or pelvic floor muscle training (PFMT), electrical stimulation (ES), and vaginal cones.…”

Conservative Treatment of Stress Urinary Incontinence: A Systematic Review with Meta-analysis of Randomized Controlled Trials

“…2,3 Its impact on quality of life is significant, leading to physical and social limitations, shame, and increased rates of depressive symptoms. 4 Stress urinary incontinence (SUI) is the most common subtype of UI, and its treatment is predominantly surgical, particularly after the introduction of synthetic midurethral slings in the mid-nineties, which led to less invasive surgical procedures. Despite its efficacy, surgical treatment may lead to complications, directly or indirectly related to the use of synthetic materials.…”