Medicina· 2026Q2
Treatment Gaps in Women Aged 65 Years and Older with Stress or Stress-Predominant Mixed Urinary Incontinence: Age-Stratified Patterns of Active Therapy, Containment Use, Frailty, and Anxiety
- 0citations
- Q2SCImago
- 2026year
Short summary
Older women with urinary incontinence are less likely to receive active treatment and more likely to rely on containment products as they age, with treatment-gap prevalence rising from 33.8% in 65-74 year olds to 55.0% in those 85+, though symptom burden, not age itself, was the stronger predictor in adjusted models.
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Key points
- Treatment-gap prevalence for urinary incontinence in women aged 65+ increased with age, from 33.8% (65-74) to 44.4% (75-84) and 55.0% (≥85).
- Active treatment use, including pelvic floor muscle training and previous continence surgery, significantly declined with increasing age strata.
- Higher symptom burden (ICIQ-UI SF score) and stress-predominant mixed incontinence remained independently associated with the treatment gap after adjustment.
- Age was not independently associated with the treatment gap after accounting for symptom burden and other factors.
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Abstract
Background and Objectives: Older women with stress or stress-predominant mixed urinary incontinence may rely on pads or diapers despite bothersome symptoms. We examined age-stratified treatment patterns and whether age remained associated with a treatment gap after accounting for frailty and symptom burden. Materials and Methods: This single-center observational study combined record review (December 2023–April 2026) with a questionnaire assessment (19 June–3 August 2026). Within the 65–74, 75–84, and ≥85-year strata, 185, 182, and 183 women were screened; after 25, 22, and 23 exclusions or incomplete assessments, respectively, 160 evaluable women remained in each stratum. The treatment gap required International Consultation on Incontinence Questionnaire-Urinary Incontinence Short Form (ICIQ-UI SF) score ≥ 8, daily pad/diaper use, pad/diaper-only management, and no active treatment in the previous 12 months. Frailty and anxiety were assessed with the fatigue, resistance, ambulation, illnesses, and loss of weight (FRAIL) scale and Geriatric Anxiety Inventory. Results: Treatment-gap prevalence was 33.8%, 44.4%, and 55.0%. Supervised pelvic floor muscle training declined from 55.0% to 40.0% and 25.0%; recent active treatment from 50.0% to 35.0% and 20.0%; and previous continence surgery from 30.0% to 18.1% and 8.1%. After adjustment, age was not independently associated. Higher ICIQ-UI SF scores [adjusted odds ratio (aOR) 1.10 per point, 95% confidence interval (CI) 1.02–1.19] and stress-predominant mixed incontinence (aOR 1.53, 95% CI 1.03–2.25) remained associated. Conclusions: Containment dependence increased and active-treatment exposure decreased with age, but symptom burden and phenotype explained more adjusted risk than age. Regular reassessment may distinguish appropriate containment from remediable under-treatment.
The authors' abstract, as published at the source. Medicina, 2026 · DOI ↗
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Field: Rheumatology
RheumatologyMedicine