Gender Disparities in the Prevalence, Trends, and Determinants of Later-Life Urinary Incontinence: A Disproportionate Burden on Women.

Abstract

Objectives: Urinary incontinence (UI) significantly deteriorates the quality of life in the elderly, with a disproportionately higher burden among women. With populations aging in the USA and the UK, understanding the gender-specific prevalence, determinants, and future care needs in UI is critical for shaping gender-responsive health policies and care strategies.

Methods: Data from the Health and Retirement Study (HRS, 2010-2020) and the English Longitudinal Study of Aging (ELSA, 2009-2019) involving participants aged 50 and older were analyzed. UI was assessed through self-reported urinary leakage during the last 12 months. The prevalence, determinants, and future care needs were estimated by gender.

Results: The analysis included 111,049 and 52,972 observations from HRS and ELSA, respectively. The findings revealed a steady increase in UI prevalence during the 2010s in males (HRS 11.2%-15.1%, ELSA 7.2%-12.0%) and females (HRS 31.4%-36.3%, ELSA 21.0%-28.1%). Contributory factors included aging, higher education levels, and comorbidities. Projections indicate a rise in UI-related care needs in the USA (HRS Female: from 22.1 to 25.7 million, Male: from 7.8 to 9.8 million) and the UK (ELSA Female: from 3.6 to 4.2 million, Male: from 1.4 to 1.6 million) during the 2020s, with women accounting for 65% of this growth, among which the fastest growth was among those aged 80 and over.

Conclusions: The rising prevalence of UI, particularly among women, alongside population aging in the USA and UK necessitates an escalation in gender-responsive expansion of care services. Gender-sensitive counseling on tailored prevention strategies and care services such as weight loss and Kegel exercises should be provided to support quality of life and healthy aging, especially in women.