The proposed research is designed to determine the prevalence and incidence of urinary incontinence by type (urge, stress and mixed), frequency and severity; to determine risk factors for urinary incontinence; to test the effectiveness of hormone therapy to decrease risk for developing urinary incontinence; and to improve the severity of urinary incontinence in elderly women.
The research aims will be achieved b analyzing data from an established study of osteoporotic fractures (SOF) and from an established heart and estrogen-progestin replacement study (HERS). The former (SOF) is a prospective cohort study of risk factors for osteoporotic fractures among 9704 women 65 years of age or older, while the latter (HERS) is a randomized trial of hormone therapy to prevent recurrent heart disease events in 2763 postmenopausal women with heart disease. Both provide measures of incontinence that will allow calculation of prevalence and information on a large number of potential risk factors including age, reproductive history, obesity, medical illnesses, medications, social habits, and physical performance. Identifications of risk factors will guide the development of randomized trials of the efficacy of preventable or modifiable factors. Ancillary measurements appended to these studies will provide data on incidence of incontinence. As a large randomized trial, HERS will provide definitive data on the efficacy of hormone therapy to prevent the development or urinary incontinence and as treatment for incontinence.
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