Urinary incontinence, sense of control/autonomy and social participation in community-dwelling older adults

Abstract

Abstract Objective Identify the presence of urinary incontinence (UI) symptoms and test a model of direct and indirect associations with the psychosocial variables sense of control/autonomy and social participation in community-dwelling older adults. Method Cross-sectional study conducted with 419 adults aged 72 years or over (70.2% female) participating in the follow-up survey of the FIBRA Study - Polo Unicamp. Age, sex and educational level were the sociodemographic variables selected as antecedents of the relationship between UI and social participation. A sense of control/autonomy was tested as a mediator of these relationships in a path analysis through structural equation modelling. Results UI was reported by 38% of the sample, with significant differences according to sex (41% female versus 31.3% male). Three levels of social participation were proposed, based on the degree of interaction between the individual and society. The model of relationships explained 15% of the variance in social participation. Direct effects were observed between control/autonomy and social participation; indirect effects between education and participation, mediated by the presence of UI. Conclusion UI contributed to restrictions in social participation at all levels. Control/autonomy, although related, did not prove to be a psychological mediator for the relationship between UI and participation. The presence of UI potentialized the disadvantageous relationships between education and social participation. As modifiable factors, the treatment and management of UI through clinical and psychosocial initiatives can act to reduce negative psychological effects and reduce socioeconomic inequalities in social participation.