Urinary incontinence and waist circumference in older women*

Methods: a cross-sectional study was conducted in southern Brazil. A sample of 1,069 urban women, age 60+, was assessed for UI (in-person interview), adiposity (body mass index [BMI] and waist circumference [WC]) and fitness. Logistic regression models were developed to assess the association between UI and the independent variables-adiposity (BMI and WC) and fitness indicators. All models were adjusted for age, socioecomomic level, diabetes and hypertension. Results: BMI and functional tests were not significantly associated with UI. WC was an independent and significant predictor. Relative to women in the lowest quartile of WC, odds ratios for UI were 1.98 for WC of 79-86 cm, 2.07 for WC of 86-94 cm and 2.24 for WC > 94 cm (P = 0.03). Conclusion: central adiposity, as indicated by large WC, increases the risk of UI. Intra-abdominal pressure and its effect on urethral structures may be responsible for this increased risk. Older women should be counselled on the risk of central obesity for UI.