Sarcopenic Obesity as a Key Determinant of Urinary Incontinence in Older Women

Urinary incontinence (UI) is a common geriatric syndrome that adversely affects quality of life. Sarcopenia and sarcopenic obesity (SO) may increase vulnerability to UI through the interplay of muscle weakness and excess adiposity, yet their contribution in older women is not well established. This study examined the prevalence of UI across women with sarcopenia and SO and explored its associations with other geriatric syndromes.

In this cross-sectional study, 535 community-dwelling women aged ≥ 60 years attending a geriatrics outpatient clinic underwent comprehensive geriatric assessment. Sarcopenia risk was screened using the SARC-F questionnaire, muscle strength measured by handgrip dynamometry, and muscle mass estimated via bioelectrical impedance analysis. Obesity was defined by BMI, waist circumference, or body fat percentage, and SO was defined as the coexistence of sarcopenia and obesity. Logistic regression was used to identify independent predictors of UI.

UI was reported by 49.9% of participants. Women with UI had higher BMI, more frequent falls, greater frailty, depressive symptoms, higher SARC-F scores, and a greater prevalence of SO. Among the three adjustment methods for SMMI, only BMI-adjusted values showed an association with UI. In multivariable logistic regresion models, fall history (aOR 2.05, 1.38-3.02), SARC-F score (aOR 1.12, 1.02-1.22) and BMI-defined SO (aOR 1.80, 1.09-2.96) independently predicted UI.

SO, sarcopenia risk, and fall history are key determinants of UI in older women. Incorporating muscle and adiposity assessment into continence evaluation may support earlier interventions to maintain continence and independence in this population.