# Sex-specific differences in urinary incontinence associated factors in older adults: an analysis of the German health update study (GEDA 2019/2020-EHIS)

## TL;DR

This study finds that urinary incontinence is more common in older women than men and identifies factors like obesity and chronic diseases as key contributors in women.

## Contribution

The study reveals sex-specific risk factors for urinary incontinence in older adults, emphasizing the role of BMI and chronic diseases in females.

## Key findings

- UI prevalence was 14.7% in older adults, with significantly higher rates in females (17.8%) compared to males (11.1%).
- Female sex, age over 85, poor health, ADL limitations, and depressive symptoms were consistently associated with UI.
- In females only, obesity (BMI ≥30), lower education, and chronic diseases were linked to increased UI risk.

## Abstract

Urinary incontinence (UI) is a common condition with significant health and societal implications, particularly among older adults. This study aims to analyze sex-specific differences in associated factors among adults aged 55+.

Data from the cross-sectional German Health Update Study (GEDA 2019/2020-EHIS), conducted April 2019 to September 2020, were analyzed for participants aged 55 + years. Differences in UI prevalence by sex were analyzed along possible associated variables (e.g. BMI, education, depressive symptoms (PHQ-8 Score), chronic diseases (any condition expected to last for at least 6 months, self-reported), and limitations of activities of daily living, ADL). UI prevalence was analyzed with 95% confidence intervals (CI). To test for sex differences in associated factors, multivariable logistic regressions were performed.

Among 12,985 participants, UI prevalence was 14.7% and higher in females (17.8%, 95% CI 16.3–19.4) than males (11.1%, 95% CI 9.8–12.5). Female sex (OR 1.40, 95% CI 1.15–1.70, p < 0.001), age 85 + years (OR 7.07, 95% CI 4.88–10.24, p < 0.001), poor subjective health (OR 1.88, 95% CI 1.50–2.36, p < 0.001), ADL limitations (OR 1.75, 95% CI 1.24–2.48, p = 0.002), and depressive symptoms (OR 2.63, 95% CI 1.84–3.75, p < 0.001) were associated with UI in the multivariable regression. Sex-specific analysis found BMI ≥ 30 (OR 2.07, 95% CI 1.52–2.84, p < 0.001), lower education (OR 1.73, 95% CI 1.27–2.36, p < 0.001) and chronic diseases (OR 1.37, 95% CI 1.01–1.86, p = 0.042) associated with UI only in females.

The self-reported UI prevalence in the general population is higher among females, but also every 9th male is affected. Due to its prevalence and possible impact on quality of life, attending physicians should have increased awareness of UI among older adults and actively offer treatment options.