Associations of urinary incontinence, physical activity and cardiovascular disease risk among women in the United States

Abstract

Objective: Urinary incontinence (incontinence) is a common condition among women which may contribute to low moderate-to-vigorous physical activity (MVPA). Thus, women with incontinence may have increased risk for inactivity and related cardiovascular disease (CVD). The objective of this study was to determine the associations of incontinence with MVPA and CVD risk. Methods: This retrospective observational study used electronic medical records to capture data on incontinence diagnosis, self-reported MVPA using the Exercise Vital Sign, CVD risk factors and diagnosis using ICD-10 codes, and demographic information from July 2022–June 2024 in Connecticut. Multinomial logistic regression assessed the association of incontinence and MVPA classification (inactive: 0 min/week, insufficiently active: 1–149 min/week, and active ≥150 min/week). Logistic regression models assessed associations of incontinence with CVD risk calculator components and diagnosed CVD. All models adjusted for age, race, body mass index, and tobacco use. Results: Of 20,155 women who were included in analysis (mean age 50.36 ± 16.42 years), 5.4 % had an incontinence diagnosis. Compared to those without incontinence, those with incontinence did not differ in MVPA classification, but had greater odds of type two diabetes (aOR 1.25, 95 % CI: 1.06–1.48), dyslipidemia (aOR 1.37, 95 % CI: 1.19–1.58), stroke (aOR 1.55, 95 % CI: 1.06–2.25), and coronary artery bypass grafts (aOR 3.17, 95 % CI: 1.45–6.95) after adjustment. Conclusions: Incontinence was not associated with MVPA classification but was associated with inactivity related CVD risk factors and cardiometabolic comorbid conditions. Future studies should investigate potential mechanisms of this association including incontinence severity, activity intensity, and chronic inflammation.