The Impact of Urinary Incontinence on the Quality of Life Among Korean Older Adults

De Gagne, Jennie Chang

Background & Purpose: Urinary incontinence (UI) has been reported to affect physical, social, and psychological health and well-being, including limitations in daily social activities, anxiety, and depression. Importantly, the prevalence of UI increases with age and frailty. The purpose of this study was to examine the relationship between UI and the quality of life in frail older adults aged 50 years and older in rural areas in South Korea.

Methods: Using a self-administered questionnaire, a descriptive cross-sectional study was conducted with 400 community-dwelling elderly women under home health nursing care of community health centers in South Korea. The quality of life, the dependent variable, was measured with EuroQoL (EQ-5D) which has five dimensions with scores ranging from 0.0 (death) to 1.0 (perfect health). The causal relationship between types of UI and EQ-5D was examined with ANOVA. We also examined whether women with UI showed different levels of EQ-5D dimensions as compared to women without UI.

Results: The prevalence of UI was evenly distributed (44.5% of the sample had UI). The types of UI were: stress UI 22.5%, urge UI 28.1%, and mixed 49.4%. The quality of life score was significantly different among the three types of UIs: Mixed UI (Mean=.73, SD=.13) < Urge UI (Mean=.76, SD=.09) < Stress UI (Mean=.79, SD=.11). Mixed UI showed the lowest EQ-5D score (F=3.50, p =.032), which was significantly different from the stress UI in post-hoc test. In the five dimensions of EQ-5D, women with UI showed significantly different lower scores than those without UI in four dimensions: activity ability (χ²=10.52, p =.001), self-care (χ²=17.16, p =<.001), pain/discomfort (χ²=5.22, p =.022), and anxiety/depression (χ²=3.97, p =.046).

Conclusion: The results suggest that patients with mixed UI should receive better care, as compared with other types of UI in order to improve their quality of life. The application of a proper UI management program at the community level is warranted to improve frail elder women’s quality of life.