Incontinence, depression & middle age

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A US study in middle-aged women 5 has found a strong link between incontinence and depression, and the authors suggest that all middle-aged women presenting for treatment of urinary incontinence be screened for coexisting depression.

The population-based cross-sectional study was conducted in 5,701 women aged between 50 and 69 years who were participating in a health and retirement study. The results showed that approximately 16% of the population reported either mild-moderate or severe incontinence. Factors associated with incontinence included depression, race, age, body mass index, medical comorbidities, and limited activities of daily living.

After adjusting for other variables, the authors found that women with severe incontinence were 80% more likely to suffer depression than continent women; women with mild-moderate incontinence were 40% more likely to suffer depression than their continent peers.

An editorial in American Family Physician by Dr Anne Walling6 discusses the study findings. Dr Walling says, “This study validates the effort of taking an extra minute to ask all middle-aged women about these conditions. Patients may hesitate to disclose symptoms of depression or incontinence, but both conditions are treatable.”

5. Nygaard I, et al. Urinary incontinence and depression in middle-aged United States women. Obstet Gynecol, 2003; 101:149-56.