Prevalence of Urinary Incontinence in the United States 2015-2020

Urinary incontinence (UI) affects quality of life and imposes substantial health care costs. Updated U.S. prevalence estimates are needed, as national data are more than a decade old.

The objective of this study was to estimate the weighted prevalence of symptomatic UI among women in the United States from 2015 to 2020.

This was a cross-sectional analysis of nonpregnant women aged 20 years or older in the 2015-March 2020 National Health and Nutrition Examination Survey (NHANES), a nationally representative survey of the U.S. population. Symptomatic UI was defined as an Incontinence Severity Index score ≥3. Subtypes were categorized as stress, urgency, or mixed. Weighted prevalence estimates were calculated and compared with previously published NHANES data. Associations with clinical and demographic factors were examined with multivariable logistic regression.

Among 6,446 participants, the weighted prevalence of UI was 22.3% (95% CI, 20.8-23.8), significantly higher than the 17.1% reported in 2005-2010 (P<0.001). Mixed UI was most common (46.6%), followed by stress (16.2%) and urgency (9.5%). In adjusted models, body mass index (BMI) ≥30 (odds ratio [OR], 2.74; 95% CI, 2.07-3.63), BMI 25.0-29.9 (OR, 1.78; 95% CI, 1.34-2.36), ≥3 comorbidities (OR, 2.12; 95% CI, 1.54-2.93), and increasing age (OR, 1.04 per year; 95% CI, 1.03-1.04) were significantly associated with UI.

More than 1 in 5 U.S. women report symptomatic UI, a significant increase compared with prior estimates. Increasing prevalence may reflect population aging and increasing obesity rates.