Association between Diabetes Mellitus and Urinary Incontinence in Elderly Patients

Abstract

Background and Aim: Urinary incontinence (UI) has been known as a problem associated with diabetes, especially in elderly. The aging process and geriatric syndromes contribute to the incidence of UI. The aim of the study was to assess UI and related factors in elderly diabetic patients. Materials and Methods: We conducted a cross-sectional study on 322 diabetic patients aged ≥ 60 years, who were admitted to the National Geriatric Hospital from December 2016 to December 2017. The 3 Incontinence Questions (3IQ) was used to identify the prevalence of UI and its classification. Information on socio-demography, medical history, glycaemic control [fasting plasma glucose (FPG) and HbA1c], co-morbidities (Charlson index), polypharmacy, and cognitive impairment were assessed to investigate the relationship of diabetes mellitus and UI. Results: Three hundred twenty two patients were recruited. Age of subjects was ranging between 60 and 96 years old (average age: 74.8 ± 8.28 years). The prevalence of UI among patients with diabetes was 65.2%. The prevalence of urge, stress, overflow and mixed incontinence were 36.7%, 36.2%, 17.6% and 9.5%, respectively. Advanced age and overweight status were associated with UI (p<0.05). The level of FPG and HbA1c among the incontinence diabetic patients were significantly higher than those in the continence diabetic patients (p<0.05). Multiple logistic regressions revealed risk factors for UI including: age > 70 years old (OR: 1.7, 95% CI: 1.1-2.7, p<0.05); history of pelvic surgery (OR:4.5, 95% CI: 1.6-12.8, p<0.05); long duration of diabetes (OR:2.8, 95% CI:1.6-4.9, p<0.001); Charlson index (OR: 2.7, 95% CI: 1.7-4.3, p<0.001); polypharmacy (OR: 2.9, 95% CI: 1.4-5.7, p<0.05); cognitive impairment (OR:40.5, 95% CI: 5.0-329.9, p=0.001). Conclusion: Advanced age, long duration of diabetes, the level of FPG and HbA1c, comorbidities, polypharmacy and cognitive impairment were associated with increased risk of urinary incontinence in elderly diabetic patients. Disclosure H.T. Vu: None.