Abstract
OBJECTIVES: To investigate the association between self-reported urinary incontinence (UI) and sexual health in a representative sample of older people. SUBJECTS AND METHODS: Participants were community-dwelling women and men aged 50-90+ years from the English Longitudinal Study of Ageing (ELSA) who reported any sexual activity in the last year. The prevalence of UI was assessed both cross-sectionally (ELSA Wave 6; 2012) and retrospectively over the preceding 8 years (ELSA Waves 2-6; 2004-2012). Sexual activities, difficulties and concerns were assessed using a validated Sexual Relationships and Activities Questionnaire. The association between UI and sexual health outcomes was examined using weighted logistic regressions, with adjustments made for demographic, health, and lifestyle factors. RESULTS: At Wave 6, 391 (20.0%) women and 141 (6.9%) men reported 'any UI' in the last 12 months. Compared to those without UI, women with UI reported declines in sexual activity and arousal over the last year, and increased concern about their frequency of sexual activity and ability to become sexually aroused. Men with 'any UI' reported declines in sexual desire, increased erectile and orgasm difficulties, and were more concerned about these sexual functions compared to men without UI. Differences in the patterns of association with sexual health were seen, dependent upon whether UI was reported as sporadic or persistent, and also with respect to the duration of retrospectively reported UI. CONCLUSION: Self-reported UI was associated with impairment in sexual health in women and men, and mainly linked to recent declines in sexual activity and function along with elevated sexual concerns. Our findings highlight that the sexual health of older people should be considered when managing UI.