Urinary and fecal incontinence and quality of life in African Americans

Objectives: To investigate associations between quality of life (QoL) and incontinence in a population-based African-American sample. Design: Cross-sectional survey. Setting: Metropolitan St. Louis, Missouri. Participants: Eight hundred fifty-three non-institutionalized African Americans aged 52 to 68 in the African American Health study. Measurements: Respondents who reported having involuntarily lost urine over the previous month were classified as having urinary incontinence (UI), and respondents who reported having lost control of their bowels or stool over the past year were classified as having fecal incontinence (FI). QoL was measured using the Medical Outcomes Study 36-Item Short-Form Health Survey (SF-36) and the 11-item Center for Epidemiologic Studies Depression Scale (CES-D). Results: Prevalences of UI and FI were 12.1% (weighted n=102/841) and 5.0% (weighted n=42/841). Participants with UI and those with FI had worse SF-36 scores than their referent groups (physical function -15.5 and -38.1 points, respectively; role physical -13.2 and -26.5 points; bodily pain -15.7 and -24.5 points; general health perceptions -15.5 and -27.6 points; vitality -15.0 and -16.5 points; social functioning -18.4 and -25.6 points; role emotional -13.2 and -22.1 points; mental health -12.2 and -17.5 points; all Ps<.001), adjusting for age, sex, body mass index, and chronic conditions. Proportions with clinically relevant levels of depressive symptoms were also higher in both groups (UI+17.9%; P<.001) and FI (+37.2%; P<.001) than in their referent groups. Conclusion: UI and FI were strongly associated with worse health-related QoL as well as symptoms of depression in this population-based sample of African Americans.