Background There are no prospective studies on the association between multimorbidity and urinary incontinence (UI), while mediators in this association are unknown. Thus, we aimed to (i) investigate the longitudinal association between multimorbidity and UI in a large sample of Irish adults aged ≥50 years and (ii) investigate to what extent physical activity, polypharmacy, cognitive function, sleep problems, handgrip strength and disability mediate the association. Methods Data on 5,946 adults aged ≥50 years old from the Irish Longitudinal Study on Aging were analysed. The baseline survey was conducted between 2009 and 2011 and follow-up after 2 years was conducted. Information on self-reported occurrence of UI in the past 12 months and lifetime diagnosis of 14 chronic conditions were obtained. Multivariable logistic regression and mediation analysis were conducted. Results After adjustment for potential confounders, compared to having no chronic conditions at baseline, having three (odds ratio [OR] = 1.79; 95% confidence interval [CI] = 1.30–2.48) and four or more (OR = 1.86; 95% CI = 1.32–2.60), chronic conditions were significantly associated with incident UI. Mediation analysis showed that polypharmacy, sleep problems and disability explained 22.7, 17.8 and 14.7% of the association between multimorbidity (i.e. two or more chronic conditions) and incident UI, respectively. Conclusion A greater number of chronic conditions at baseline were associated with a higher risk for incident UI at 2-year follow-up among adults aged ≥50 years in Ireland. Considering the effects of different medications on UI and improving sleep quality and disability among people aged ≥50 years with multimorbidity may reduce the incidence of UI.

中文翻译：

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≥50 岁社区居民的身体多病和偶发性尿失禁：爱尔兰老龄化纵向研究的前瞻性分析结果

背景 没有关于多发病与尿失禁 (UI) 之间关联的前瞻性研究，而这种关联的介质尚不清楚。因此，我们旨在 (i) 在 50 岁以上的爱尔兰成年人的大样本中调查多病与 UI 之间的纵向关联，以及 (ii) 调查身体活动、多种药物、认知功能、睡眠问题、握力和残疾的程度调解协会。方法分析了来自爱尔兰老龄化纵向研究的 5,946 名 50 岁以上成年人的数据。基线调查于 2009 年至 2011 年间进行，并在 2 年后进行了随访。获得了过去 12 个月内自我报告的 UI 发生率和 14 种慢性病的终生诊断信息。进行多变量逻辑回归和中介分析。结果 在调整潜在混杂因素后，与基线时没有慢性病相比，有三个（优势比 [OR] = 1.79；95% 置信区间 [CI] = 1.30-2.48）和四个或更多（OR = 1.86；95% CI = 1.32–2.60），慢性病与 UI 事件显着相关。中介分析表明，多种药物、睡眠问题和残疾分别解释了多种疾病（即两种或两种以上慢性病）与 UI 事件之间关联的 22.7%、17.8% 和 14.7%。结论：在爱尔兰 50 岁以上的成年人中，基线时更多的慢性病与 2 年随访时发生 UI 的风险更高相关。