Incontinence is a common condition that few women discuss with their medical provider. In this grant application, we propose to capitalize on the availability of two large prospective studies of women aged 37-85 years, to examine the epidemiology of urinary incontinence (UI) across varying age groups. Although parity is an established predictor of incontinence, detailed data on reproductive characteristics are sparse, and large prospective epidemiologic studies on additional risk factors are rare; in particular, since lifestyle may change as a result of incontinence, it is essential to identify and confirm associations in prospective data so that cause and effect are not misappropriated. We plan to examine prospectively the relation of reproductive characteristics, body weight and physical activity, and hormonal factors to the incidence of UI, to different types of UI (urge, stress, or mixed incontinence), to its severity, its progression, and to its impact on women s daily lives. The investigation will utilize the Nurses Health Study and the Nurses Health Study II, observational studies of 121,701 and 116.678 female nurses, respectively. Extensive data are collected via biennial, mailed questionnaires (since 1976 for NHS and since 1989 for NHSII) regarding lifestyle and numerous diseases. This includes updated reproductive information, body weight, exercise habits, menopause, exogenous hormone use, and many other items. Details regarding incontinence will be established via a comprehensive supplementary questionnaire to all women who report leaking on the main questionnaires; this will elicit data on type of incontinence, treatment, and extent to which the incontinence is bothersome or restrictive. Based on preliminary data from NHS, the 33.8% prevalence of incontinence is similar to that reported by other groups, and the 3.2% four-year incidence rate is comparable to that in the few existing follow-up studies. These similarities indicate the nurse participants report incontinence accurately and that our data are generalizable to other populations. Both NHS and NHSII have maintained extremely high participation (over 909~ in both studies to date). These two existing cohorts provide a cost-efficient basis for conducting a prospective study of UI, allowing better understanding of the epidemiology of UI, and identification of preventive strategies. In addition, the establishment of these cohorts for studying incontinence will allow future investigations of many other issues, such as the effect of diet and various lifestyle habits.
| Townsend, Mary K; Minassian, Vatché A; Okereke, Olivia I et al. (2014) Urinary incontinence and prevalence of high depressive symptoms in older black versus white women. Int Urogynecol J 25:823-9 |
| Minassian, Vatche A; Devore, Elizabeth; Hagan, Kaitlin et al. (2013) Severity of urinary incontinence and effect on quality of life in women by incontinence type. Obstet Gynecol 121:1083-90 |
| Matthews, Catherine A; Whitehead, William E; Townsend, Mary K et al. (2013) Risk factors for urinary, fecal, or dual incontinence in the Nurses' Health Study. Obstet Gynecol 122:539-45 |
| Townsend, Mary K; Resnick, Neil M; Grodstein, Francine (2012) Caffeine intake and risk of urinary incontinence progression among women. Obstet Gynecol 119:950-7 |
| Devore, Elizabeth E; Townsend, Mary K; Resnick, Neil M et al. (2012) The epidemiology of urinary incontinence in women with type 2 diabetes. J Urol 188:1816-21 |
| Townsend, Mary K; Devore, Elizabeth E; Resnick, Neil M et al. (2012) Acidic fruit intake in relation to incidence and progression of urinary incontinence. Int Urogynecol J : |
| Jura, Ying H; Townsend, Mary K; Curhan, Gary C et al. (2011) Caffeine intake, and the risk of stress, urgency and mixed urinary incontinence. J Urol 185:1775-80 |
| Townsend, Mary K; Jura, Ying H; Curhan, Gary C et al. (2011) Fluid intake and risk of stress, urgency, and mixed urinary incontinence. Am J Obstet Gynecol 205:73.e1-6 |
| Townsend, Mary K; Curhan, Gary C; Resnick, Neil M et al. (2011) Original research: rates of remission, improvement, and progression of urinary incontinence in Asian, Black, and White women. Am J Nurs 111:26-33; quiz 34-5 |
| Townsend, Mary K; Curhan, Gary C; Resnick, Neil M et al. (2010) The incidence of urinary incontinence across Asian, black, and white women in the United States. Am J Obstet Gynecol 202:378.e1-7 |
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