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Association between urinary incontinence and frailty: a systematic review and meta-analysis

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Abstract

Purpose

Urinary incontinence (UI) and frailty are common geriatric syndromes. Although literature increasingly supports a relationship between these two conditions, no systematic review and meta-analysis has been performed on this topic. Therefore, we aimed to investigate the potential association between UI and frailty, through a meta-analytic approach.

Methods

A systematic search in major databases was undertaken until 15th March 2018 for studies reporting the association between UI and frailty. The prevalence of UI in people with frailty (vs. those without) was pooled through an odds ratio (OR) and 95% confidence intervals (CIs), with a random-effects model. The other outcomes were summarized descriptively.

Results

Among 828 papers, 11 articles were eligible, including 3784 participants (mean age 78.2 years; 55.1% women). The prevalence of UI was 39.1% in people with frailty and 19.4% in those without. A meta-analysis with five studies (1540 participants) demonstrated that UI was over twice as likely in frail people versus those without (OR 2.28; 95% CI 1.35–3.86; I2 = 61%). One cross-sectional study, adjusting for potential confounders and one longitudinal study confirmed that UI is significantly associated with frailty. In two cross-sectional studies, using adjusted analyses, frailty was more common in people with UI.

Conclusion

Urinary incontinence is twice as common in older people with frailty compared to older people without frailty. Screening and the development of interventions for UI and frailty could prove useful for this common comorbidity.

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Acknowledgements

Special Interest Group on UI includes: L. Aharony, Community Geriatric Service, Haifa and Western Galilei District, Calit Health Services, Haifa, Israel; J. De Cock, Geriatric Department, Universitair Ziekenhuis Brussel, Brussels, Belgium; M.S. Nuotio, Seina¨sjoki Central Hospital, Seina¨sjoki, Finland; C. Pedone, Universita` Campus Bio-Medico di Roma, Rome, Italy; J. Rifel, University of Ljubljana, Faculty of Medicine, Family Medicine Department, Ljubljana, Slovenia; N. Vande Walle, Geriatric Department, Universitair Ziekenhuis Brussel, Brussels, Belgium; A. Velghe, Department of Geriatric Medicine, Ghent University Hospital, Gent, Belgium; A. Vella, Department of Geriatric Medicine, Malta Medical School, University of Malta, Msida, Malta.

Special Interest Group of Systematic reviews and meta-analysis for healthy ageing includes: M. Solmi, University of Padova, Padova, Italy; A. Koyanagi, Parc Sanitari Sant Joan de Déu/CIBERSAM, Universitat de Barcelona, Fundació Sant Joan de Déu, Sant Boi de Llobregat, Barcelona, Spain; T. Thompson, Faculty of Education and Health, University of Greenwich, London, United Kingdom; C. Beudart, Department of Public Health, Epidemiology and Health Economics, University of Liege, Liege, Belgium; O. Bruyère, Department of Public Health, Epidemiology and Health Economics, University of Liege, Liege, Belgium; G. Torbahn, Institute of Social Paediatrics and Adolescent Medicine, LMU Munich, Munich, Germany; J. Firth, NICM, School of Science and Health, University of Western Sydney, Australia; Division of Psychology and Mental Health, University of Manchester, UK; L. Smith, The Cambridge Centre for Sport & Exercise Sciences, Anglia Ruskin University, Cambridge, UK.

Funding

This work was not supported by any funding.

Author information

Authors and Affiliations

  1. National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy

    Nicola Veronese & Stefania Maggi

  2. Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey

    Pinar Soysal

  3. Physiotherapy Department, South London and Maudsley NHS Foundation Trust, London, UK

    Brendon Stubbs

  4. Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King’s College London, London, UK

    Brendon Stubbs

  5. Faculty of Health, Social Care and Education, Anglia Ruskin University, Chelmsford, UK

    Brendon Stubbs

  6. Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy

    Alessandra Marengoni

  7. Primary Care Department, Azienda USL Toscana Sud Est, Grosseto, Italy

    Jacopo Demurtas

  8. Department of Internal Medicine (Geriatrics), Ghent University, Ghent, Belgium

    Mirko Petrovic

  9. Department of Geriatric Department, Hospital Universitario Clinico San Carlos, Madrid, Spain

    Carlos Verdejo-Bravo

Authors
  1. Nicola Veronese
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  4. Alessandra Marengoni
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Consortia

The Special Interest Group on Urinary Incontinence

  • L. Aharony
  • , J. De Cock
  • , M. S. Nuotio
  • , C. Pedone
  • , J. Rifel
  • , N. Vande Walle
  • , A. Velghe
  •  & A. Vella

The Special Interest Group of Systematic Reviews and Meta-Analysis for Healthy Aging, European Geriatric Medicine Society (EuGMS)

  • M. Solmi
  • , A. Koyanagi
  • , T. Thompson
  • , C. Beudart
  • , O. Bruyère
  • , G. Torbahn
  • , J. Firth
  •  & L. Smith

Corresponding author

Correspondence to Nicola Veronese.

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Conflict of interest

The authors declare that they have no conflict of interest.

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This article does not contain any studies with human participants or animals performed by any of the authors.

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None.

Additional information

The members of the Special Interest Group on Urinary Incontinence and the Special Interest Group of Systematic Reviews and Meta-Analysis for Healthy Aging, European Geriatric Medicine Society (EuGMS) are listed below in the acknowledgements.

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Veronese, N., Soysal, P., Stubbs, B. et al. Association between urinary incontinence and frailty: a systematic review and meta-analysis. Eur Geriatr Med 9, 571–578 (2018). https://doi.org/10.1007/s41999-018-0102-y

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  • DOI: https://doi.org/10.1007/s41999-018-0102-y

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