Risk for symptoms of depression may be associated with urinary incontinence (UI) which was mediated by functional impairment among middle-aged and older adults. These findings, from a cross-sectional study, were published in the Journal of Affective Disorders.

Data for this study were sourced from the English Longitudinal Study of Aging (ELSA) which is an ongoing longitudinal survey of individuals aged 50 years and older living in England. Since 2002, participants (N=7039) have responded to surveys every 2 years and undergone health examinations every 4 years.

For this study, UI was self-reported using a yes or no question. Depression was evaluated using the Center for Epidemiologic Studies-Depression (CES-D) instrument. Functional limitations were identified using activities of daily living (ADL), instrumental activities of daily living (IADL), and mobility and large muscle group limitations.


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The study population comprised 44.25% men, aged mean 68.91±8.96 years, and 97.14% were White. More of the individuals with symptoms of depression (n=815) were women, had lower levels of education, more were current smokers, obese, had comorbidities, functional limitation, and UI (all P <.001).

UI was associated with increased risk for depressive symptoms (odds ratio [OR], 1.75; 95% CI, 1.45-2.11; P <.001).

The relationship between depression and UI was indirectly mediated (36.96%) by functional limitations (P =.005).

Stratified by gender, the relationship between UI and depression was stronger among men (OR, 2.25; 95% CI, 1.58-3.22; P <.001) than among women (OR, 1.60; 95% CI, 1.29-2.00; P <.001). Conversely, the mediation effect of functional limitations was stronger among women (39.79%; P =.041) than among men (28.83%; P =.050).

A potential limitation of this study was not having available data on causes of UI.

The study authors concluded, “This study suggests that UI is associated with increased risk of depressive symptoms among middle-aged and older adults and functional limitations partially mediate this association. Preventing or managing functional limitations and improving physically functional capacity may play an important role in reducing depressive symptoms in elderly people with UI.”

Reference

Yang X, Cheng C, Ma W, Jia C. Mediating role of functional limitations in the association of urinary incontinence with depressive symptoms among middle-aged and older adults: the English longitudinal study of aging. J Affect Disord. Published online July 3, 2022. doi:10.1016/j.jad.2022.06.075