Vitamin D and Incident Urinary Incontinence in Older Adults

OBJECTIVE: To determine if vitamin D status is associated with incident urinary incontinence (UI) among community-dwelling older adults. METHODS: The University of Alabama at Birmingham Study of Aging is a prospective cohort study of community-dwelling Medicare enrollees. Standardized assessment of UI using the validated Incontinence Severity Index. Analysis of 25-hydroxyvitamin D (25(OH)D levels was performed on stored baseline sera. UI was assessed every 6–12 months for up to 42 months. Analyses included multivariable logistic regression and Cox proportional hazard models. RESULTS: Of 350 participants (175 male, 147 black, mean age 73.6 ± 5.8), 54% (189/350) were vitamin D deficient [25(OH)D < 20 ng/mL] and 25% (87/350) were vitamin D insufficient [25(OH)D 20 ng/mL to < 30 ng/mL]. Among the 187 subjects with no UI at baseline, 57% (107/187) were vitamin D deficient and 24% (45/187) were vitamin D insufficient. 175 of the 187 subjects had follow-up evaluation for incident UI over 42 months and incident UI occurred in 37% (65/175). After adjustment cumulative incident UI at 42 months was associated with baseline vitamin D insufficiency (p=0.03) and demonstrated a trend association with deficiency (p=0.07). There was no association between baseline vitamin D status and time to incident UI. CONCLUSIONS: These preliminary results support an association between vitamin D and incident UI in community-dwelling older adults. Future studies may target specific at risk groups, such as men with BPH or women with pelvic floor disorders for evaluation of the impact of vitamin D supplementation on urinary symptoms.