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Association between urinary incontinence and frailty: a systematic review and meta-analysis

  • Veronese, Nicola1
  • Soysal, Pinar2
  • Stubbs, Brendon3, 4, 5
  • Marengoni, Alessandra6
  • Demurtas, Jacopo7
  • Maggi, Stefania1
  • Petrovic, Mirko8
  • Verdejo-Bravo, Carlos9
  • 1 National Research Council, Neuroscience Institute, Aging Branch, Padua, Italy , Padua (Italy)
  • 2 Faculty of Medicine, Bezmialem Vakif University, Department of Geriatric Medicine, Istanbul, Turkey , Istanbul (Turkey)
  • 3 South London and Maudsley NHS Foundation Trust, Physiotherapy Department, London, UK , London (United Kingdom)
  • 4 Institute of Psychiatry, Psychology and Neuroscience, King’s College London, Department of Psychological Medicine, London, UK , London (United Kingdom)
  • 5 Anglia Ruskin University, Faculty of Health, Social Care and Education, Chelmsford, UK , Chelmsford (United Kingdom)
  • 6 University of Brescia, Department of Clinical and Experimental Sciences, Brescia, Italy , Brescia (Italy)
  • 7 Azienda USL Toscana Sud Est, Primary Care Department, Grosseto, Italy , Grosseto (Italy)
  • 8 Ghent University, Department of Internal Medicine (Geriatrics), Ghent, Belgium , Ghent (Belgium)
  • 9 Hospital Universitario Clinico San Carlos, Department of Geriatric Department, Madrid, Spain , Madrid (Spain)
Published Article
European Geriatric Medicine
Springer International Publishing
Publication Date
Aug 29, 2018
DOI: 10.1007/s41999-018-0102-y
Springer Nature


PurposeUrinary incontinence (UI) and frailty are common geriatric syndromes. Although literature increasingly supports a relationship between these two conditions, no systematic review and meta-analysis has been performed on this topic. Therefore, we aimed to investigate the potential association between UI and frailty, through a meta-analytic approach.MethodsA systematic search in major databases was undertaken until 15th March 2018 for studies reporting the association between UI and frailty. The prevalence of UI in people with frailty (vs. those without) was pooled through an odds ratio (OR) and 95% confidence intervals (CIs), with a random-effects model. The other outcomes were summarized descriptively.ResultsAmong 828 papers, 11 articles were eligible, including 3784 participants (mean age 78.2 years; 55.1% women). The prevalence of UI was 39.1% in people with frailty and 19.4% in those without. A meta-analysis with five studies (1540 participants) demonstrated that UI was over twice as likely in frail people versus those without (OR 2.28; 95% CI 1.35–3.86; I2 = 61%). One cross-sectional study, adjusting for potential confounders and one longitudinal study confirmed that UI is significantly associated with frailty. In two cross-sectional studies, using adjusted analyses, frailty was more common in people with UI.ConclusionUrinary incontinence is twice as common in older people with frailty compared to older people without frailty. Screening and the development of interventions for UI and frailty could prove useful for this common comorbidity.

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