Abstract / Summary
Urinary incontinence (UI) is a common but neglected health problem in older women, and its association with physical and sexual activity remains uncertain. This study aimed to assess this association in older women participating in the Amirkola cohort study. This secondary cross-sectional analysis used data from 393 married women aged ≥ 60 years who participated in the third phase of the Amirkola Health and Aging Project (AHAP), an ongoing population-based cohort study. Data were collected in 2024–2025. We collected data using the 3IQ questionnaire (UI type), PASE (physical activity), a question on past-month sexual activity, and a demographic questionnaire. Bivariate analyses (t-test, chi-square) and multivariable logistic regression were performed using SPSS version 27. Statistical significance was set at P < 0.05. The mean age of participants was 71.12 years. The prevalence of UI was 51.1% (201 out of 393 participants). The median physical activity score was significantly higher in women without UI (199.27) compared with those with UI (172.60) ( P = 0.006). The prevalence of sexual activity was also significantly higher in women without UI (52.8%) than in those with UI (47.2%) ( P = 0.037). However, in the logistic regression model, after controlling for confounding variables, neither physical activity (OR = 0.99, 95% CI: 0.99 to 1.00, P = 0.154) nor sexual activity (OR = 0.86, 95% CI: 0.54 to 1.36, P = 0.517) showed a significant association with UI. In contrast, the number of medications taken remained the only independent significant variable (OR = 1.14, 95% CI: 1.04 to 1.24, P = 0.004). Although simple associations exist between UI and both physical and sexual activity, these did not persist after adjustment. In this cross-sectional sample of older women, the number of medications taken showed the strongest independent association with UI. However, given the cross-sectional design, these findings do not imply causation and should be confirmed in future prospective studies. The findings suggest that comprehensive health assessment may be relevant in UI management; however, due to cross-sectional design, selection bias, measurement limitations, and use of historical data, these results are hypothesis-generating and require confirmation in prospective studies.