Association between urinary incontinence and device-measured physical activity: a cross-sectional study

Determine the association between urinary incontinence and physical activity in a well-characterized and racially and ethnically diverse cohort of women. Secondarily, we aimed to determine the association between the frequency of symptoms of urinary incontinence and urinary incontinence type (stress, urge, and mixed) and accelerometer-based measures of physical activity and sedentary behavior.

A cross-sectional study of 1098 women who were enrolled in the Study of Women's Health Across the Nation, an epidemiologic study of community-dwelling women representing 5 racial/ethnic groups and 7 geographic sites across the United States. For the primary analysis, presence of urinary incontinence (<1 vs 1 leakage episode/month) was the primary predictor of selected measures of physical activity including moderate to vigorous physical activity minutes, number of moderate to vigorous physical activity bouts, duration of moderate to vigorous physical activity bouts, and sedentary minutes. Unadjusted models and models adjusted age, race, ethnicity, body mass index, parity, smoking status, mental health status, total comorbidity score, and accelerometer wear time were performed using multivariate linear regression. The same analytic approach was repeated for frequency of episodes of urinary incontinence and urinary incontinence subtypes of stress, urge, and mixed incontinence.

Average age was 65±2.7 years and was comprised of 23.5% Black, 12.5% Chinese, 11.3% Japanese, 4.9% Hispanic/Latina, and 47.8% White women. Prevalence of urinary incontinence was 65%. In unadjusted analyses, presence of any urinary incontinence was associated with increased sedentary minutes, decreased moderate to vigorous physical activity bouts, and decreased amount of time spent in moderate to vigorous physical activity bouts, but these associations were eliminated when accounting for covariates, particularly age and body mass index. However, the frequency of urinary incontinence episodes (1/week) was inversely related to the duration of moderate to vigorous physical activity bouts (beta coefficient: -3.0 minutes, 95% confidence interval: -5.77, 0.24 minutes). This association was strengthened for urgency urinary incontinence (beta coefficient: -3.70, 95% confidence interval: -6.64, 0.77). Any significant unadjusted associations in the remaining variables were primarily accounted for by body mass index.

Presence of urinary incontinence was not associated with physical activity estimates. More frequent urgency urinary incontinence episodes were associated with less time spent in moderate to vigorous physical activity. Longitudinal studies are needed to further understand impact of urgency urinary incontinence on achievement of physical activity guidelines.