Association between urinary incontinence and bone health in Korean elderly women based on data from the Korea National Health and Nutrition Examination Survey
More details
Hide details
Department of Family Medicine Jeju National University & Hospital, South Korea
Department of Family Medicine Jeju National University Hospital, South Korea
Department of Urology, Jeju National University & Hospital, South Korea
Online publication date: 2019-05-16
Publication date: 2019-05-16
Electron J Gen Med 2019;16(3):em140
Urinary incontinence and impaired bone health are significant health problems among the elderly. We evaluated the impact of urinary incontinence on bone health in the elderly.

Material and Methods:
Our study used data from the Korea National Health and Nutrition Examination. We included 901 women aged ≥ 65 years. The bone mineral density was measured by dual-energy X-ray absorptiometry. Impaired bone health was characterized by lumbar spine, femoral neck, or total femur T-scores of ≤ −1.0 SD. Each participant’s incontinence status was recorded using constructed questionnaires.

The prevalence of self-reported urinary incontinence in the women aged ≥ 65 years was 9.5%. After adjustments for age, height, and weight, the T-scores for the lumbar spine of the urinary incontinence and the no urinary continence groups were −2.48 ± 0.11 and −2.37 ± 0.03, respectively and didn’t show the difference between them (p = 0.390). Likewise, the T-scores for the total femur and femoral neck were not significantly different. After adjusting for covariates, we found no statistically significant association between impaired bone health with urinary incontinence.

This study found urinary incontinence was not an independent risk factor of impaired bone health in the elderly women.

Abrams P, Cardazo L, Fall M, et al. The standardisation of terminology in lower urinary tract function: report from the standardisation subcommittee of the International Continence Society. Urology. 2003;61(1):37–49. https://doi.org/10.1016/S0090-....
Kwon CS, Lee JH. Prevalence, risk factors, quality of life, and health-care seeking behaviors of female urinary incontinence: results from the 4th Korean National Health and Nutrition Examination Survey VI (2007–2009). Int Neurourol J. 2014;18:31–6. https://doi.org/10.5213/inj.20... PMid:24729925 PMCid:PMC3983507.
Price N, Dawood R, Jackson SR. Pelvic floor exercise for urinary incontinence: a systematic literature review. Maturitas. 2010;67:309–15. https://doi.org/10.1016/j.matu... PMid:20828949.
Stav K, Alcalay M, Peleg S, Lindner A, Gayer G, Hershkovitz I. Pelvis architecture and urinary incontinence in women. Eur Urol. 2007;52:239–44. https://doi.org/10.1016/j.euru... PMid:17207915.
Park YW, Lee JH. Female urinary incontinence and obesity assessed by anthropometry and dual-energy X-ray absorptiometry: analysis from the 2008–09 Korean National Health and Nutrition Examination Survey. Low Urin Tract Symptoms. 2017. https://doi.org/10.1111/luts.1... PMid:29119694.
Cruz-Jentoft AJ, Baeyens JP, Bauer JM, Boirie Y, Cederholm T, Landi F, Martin FC, Michel JP, Rolland Y, Schneider SM, Topinková E, Vandewoude M, Zamboni M; European Working Group on Sarcopenia in Older People. Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on Sarcopenia in older people. Age Ageing. 2010;39:412–23. https://doi.org/10.1093/ageing... PMid:20392703 PMCid:PMC2886201.
Kim TN. Diverse abnormal body composition phenotypes: interaction between muscle, fat, and bone. Korean J Obes. 2015;24:9–16. https://doi.org/10.7570/kjo.20....
Lima RM, Bezerra LM, Rabelo HT, Silva MA, Silva AJ, Bottaro M, de Oliveira RJ. Fat-free mass, strength, and sarcopenia are related to bone mineral density in older women. J Clin Densitom. 2009;12:35–41. https://doi.org/10.1016/j.jocd... PMid:19084449.
Hamrick MW. The skeletal muscle secretome: an emerging player in muscle-bone crosstalk. Bonekey Rep. 2012;1:60. https://doi.org/10.1038/boneke... PMid:23951457 PMCid:PMC3727847.
Hamrick MW, McNeil PL, Patterson SL. Role of muscle-derived growth factors in bone formation. J Musculoskelet Neuronal Interact. 2010;10:64–70.
Hamrick MW. A role for myokines in muscle-bone interactions. Exerc Sport Sci Rev. 2011;39:43–7. https://doi.org/10.1097/JES.0b... PMid:21088601 PMCid:PMC3791922.
Nygaard I, Girts T, Fultz NH, Kinchen K, Pohl G, Sternfeld B. Is urinary incontinence a barrier to exercise in women? Obstet Gynecol. 2005;106:307–14. https://doi.org/10.1097/01.AOG... PMid:16055580.
Smith MD, Coppieters MW, Hodges PW. Is balance different in women with and without stress urinary incontinence? Neurourol Urodyn. 2008;27:71–8. https://doi.org/10.1002/nau.20... PMid:17623853.
Brown JS, Vittinghoff E, Wyman JF, Stone KL, Nevitt MC, Ensrud KE, Grady D. Urinary incontinence: does it increase risk for falls and fractures? Study of the Osteoporotic Fractures Research Group. J Am Geriatr Soc. 2000;48:721–5. https://doi.org/10.1111/j.1532... PMid:10894308.
Yoo HJ. What is geriatric disease? J Korean Geriatr Soc. 2008;12:61–7.
Inouye SK, Studenski S, Tinetti ME, Kuchel GA. Geriatric syndromes: clinical, research, and policy implications of a core geriatric concept. J Am Geriatr Soc. 2007;55:780–91. https://doi.org/10.1111/j.1532... PMid:17493201 PMCid:PMC2409147.
Fuchs Z, Blumstein T, Novikov I, Walter-Ginzburg A, Lyanders M, Gindin J, Habot B, Modan B. Morbidity, comorbidity, and their association with disability among community-dwelling oldest-old in Israel. J Gerontol A Biol Sci Med Sci. 1998;53:M447–55. https://doi.org/10.1093/gerona....
Schaffer J, Fantl JA. Urogenital effects of the menopause. Baillieres Clin Obstet Gynaecol. 1996;10:401–17. https://doi.org/10.1016/S0950-....
Hextall A, Cardozo L. The role of estrogen supplementation in lower urinary tract dysfunction. Int Urogynecol J Pelvic Floor Dysfunct. 2001;12:258–61. https://doi.org/10.1007/s00192... PMid:11569655.
Męczekalski B, Podfigurna-Stopa A, Czyżyk A, Katulski K, Maciejewska-Jeske M. Why hypoestrogenism in young women is so important. Arch Perinat Med. 2014;20:78–80.
Ozbek E, Dursun M, Otunctemur A, Sami Cakir S, Can Polat E. Stress urinary incontinence in premenopausal and postmenopausal women: evaluation of serum estradiol levels and bone mineral density. Minerva Ginecol. 2014;66:293–8.
Irwin DE, Milsom I, Hunskaar S, Reilly K, Kopp Z, Herschorn S, Coyne K, Kelleher C, Hampel C, Artibani W, Abrams P. Population-based survey of urinary incontinence, overactive bladder, and other lower urinary tract symptoms in five countries: results of the EPIC study. Eur Urol. 2006;50:1306–14. https://doi.org/10.1016/j.euru... PMid:17049716.
Ueda T, Tamaki M, Kageyama S, Yoshimura N, Yoshida O. Urinary incontinence among community-dwelling people aged 40 years or older in Japan: prevalence, risk factors, knowledge and self-perception. Int J Urol. 2000;7:95–103. https://doi.org/10.1046/j.1442... PMid:10750888.
Choi H, Park JY, Yeo JK, Oh MM, Moon DG, Lee JG, Bae JH. Population-based survey on disease insight, quality of life, and health-seeking behavior associated with female urinary incontinence. Int Neurourol J. 2015;19:39–46. https://doi.org/10.5213/inj.20... PMid:25833480 PMCid:PMC4386485.
Diokno AC, Brock BM, Brown MB, Herzog AR. Prevalence of urinary incontinence and other urological symptoms in the noninstitutionalized elderly. J Urol. 1986;136:1022–5. https://doi.org/10.1016/S0022-....
Choi JB. Urinary incontinence in women. Korean J Fam Med. 2010;31:661–71. https://doi.org/10.4082/kjfm.2....
Oh SJ, Park HG, Lim SH, Hong SK, Martin ML, Ting BL, Kim SW, Kim HH, Paick JS. Translation and linguistic validation of Korean version of the Incontinence Quality of Life (I-QoL) Instrument. J Korean Continence Soc. 2002;6:10–23. https://doi.org/10.5213/jkcs.2....
Oh SJ, Choo MS, Kim HS, Kim JC, Lee JG, Yun JM, Kim DY, Paick JS, Lee JY, Chung BS, Min KS, Kim YH, Jung HC, Son H, Jeong JY, Rho J, Lee KS, Kang W, Park WH. Psychometric properties of the Korean version of the King’s health questionnaire in women with stress urinary incontinence. J Korean Continence Soc. 2005;9:115–23. https://doi.org/10.5213/jkcs.2....
Journals System - logo
Scroll to top