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Author Spotlight: Assessing Surgical Frailty with Point-of-Care Ultrasound of Quadriceps Muscles
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The Relationship Between Urinary Incontinence, Mortality, and Frailty: Insights From a Large Cohort Study.

Niharika Malviya1, Tracy Cheung1, Joseph Kim2

  • 1Albert Einstein College of Medicine, Bronx, New York, USA.

Neurourology and Urodynamics
|May 2, 2025
PubMed
Summary

Urinary incontinence (UI) in women is linked to higher mortality risk, but this association disappears when considering demographics and frailty. Frailty and demographics significantly influence the relationship between UI and mortality outcomes.

Keywords:
frailtymortalitynhanesstress incontinencesurvival analysisurge incontinenceurinary incontinence

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Area of Science:

  • Gerontology
  • Epidemiology
  • Urology

Background:

  • Urinary incontinence (UI) is a prevalent condition affecting women's quality of life.
  • The association between UI and mortality requires further investigation, particularly considering confounding factors like frailty.

Purpose of the Study:

  • To examine the relationship between urinary incontinence (UI) and all-cause mortality in women.
  • To investigate the potential mediating role of frailty in the UI-mortality association.
  • To explore differences in mortality risk across various subtypes of UI.

Main Methods:

  • Analysis of 8967 women aged 40+ from the National Health and Nutrition Examination Survey (NHANES).
  • Kaplan-Meier survival curves and Cox regression analyses were employed.
  • Models were adjusted for demographic variables and frailty scores to assess UI subtypes (UUI, SUI, OUI) and mortality.

Main Results:

  • 45.8% of participants reported UI in the past year.
  • Initial analysis revealed a significant association between UI and increased mortality risk (HR=1.478).
  • This association became non-significant after adjusting for frailty and demographic factors.

Conclusions:

  • While UI showed an increased risk of all-cause mortality in initial analyses, this link was not sustained after controlling for demographics and frailty.
  • Frailty and demographic factors appear to be significant confounders in the relationship between UI and mortality in women.