{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,2]],"date-time":"2026-06-02T21:59:29Z","timestamp":1780437569100,"version":"3.54.1"},"reference-count":42,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,1,1]],"date-time":"2024-01-01T00:00:00Z","timestamp":1704067200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Clinical Research Incubation Project"},{"name":"Beijing Chao-Yang Hospital"},{"DOI":"10.13039\/501100002799","name":"Capital Medical University","doi-asserted-by":"publisher","award":["CYFH202310"],"award-info":[{"award-number":["CYFH202310"]}],"id":[{"id":"10.13039\/501100002799","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R01 AG030153"],"award-info":[{"award-number":["R01 AG030153"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["RC2 AG036619"],"award-info":[{"award-number":["RC2 AG036619"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000049","name":"National Institute on Aging","doi-asserted-by":"publisher","award":["R03 AG043052"],"award-info":[{"award-number":["R03 AG043052"]}],"id":[{"id":"10.13039\/100000049","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,1,2]]},"abstract":"<jats:title>Abstract<\/jats:title>\n               <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>The relationship between multimorbidity (i.e. \u2265 2 chronic conditions) and incontinence (i.e. urinary and\/or faecal incontinence) is underexplored. This study investigated the association between multimorbidity and incident incontinence in Chinese adults aged \u226550\u00a0years.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Data from the 2011 and 2015 waves of the China Health and Retirement Longitudinal Study were used. The association between 12 chronic conditions, multimorbidity and new-onset incontinence was analysed using weighted logistic regression models. Mediation analysis was conducted to explore the potential mediators (self-reported health, subjective memory, depressive symptoms, disability, cognitive function, handgrip strength, mobility limitations, medications and frailty status) between multimorbidity and incontinence.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Findings<\/jats:title>\n                  <jats:p>Among 9,986 individuals aged \u226550\u00a0years who were continent at baseline, 5.3% (n\u2009=\u2009521) were newly incontinent 4\u00a0years later (incident cases). The risk of incident incontinence increased with physical multimorbidity (OR 2.04, 95% CI 1.62\u20132.57). Compared to no chronic condition, having 1, 2, 3 and\u2009\u2265\u20094 chronic conditions were associated with incident incontinence with OR (95% CI): 1.41 (1.01\u20131.97), 1.74 (1.24\u20132.44), 2.82 (1.93\u20134.12) and 3.99 (2.29\u20136.95), respectively. The association between multimorbidity and incontinence was mediated by self-reported health (41.2%), medications (26.6%), mobility limitations (20.9%), depressive symptoms (12.8%), disability (11.6%), subjective memory (8.7%) and frailty status (8.3%).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>This longitudinal study found that physical multimorbidity and specific chronic conditions may increase the risk of new-onset incontinence among Chinese adults aged \u226550\u00a0years. Self-reported health, medications and mobility limitations seemed to be important intermediate conditions between multimorbidity and incident incontinence.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/ageing\/afad258","type":"journal-article","created":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T11:35:17Z","timestamp":1705923317000},"source":"Crossref","is-referenced-by-count":5,"title":["Association of chronic conditions and physical multimorbidity with new-onset incontinence in a nationwide prospective cohort study of older adults\u2009\u2265\u200950\u00a0years in China"],"prefix":"10.1093","volume":"53","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6932-982X","authenticated-orcid":false,"given":"Haibin","family":"Li","sequence":"first","affiliation":[{"name":"Department of Cardiac Surgery , Heart Center & Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, , Beijing , China"},{"name":"Capital Medical University , Heart Center & Beijing Key Laboratory of Hypertension, Beijing Chaoyang Hospital, , Beijing , China"},{"name":"Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xinye","family":"Zou","sequence":"additional","affiliation":[{"name":"Cambridge Institute of Public Health , School of Clinical Medicine, , Cambridge , UK"},{"name":"University of Cambridge , School of Clinical Medicine, , Cambridge , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruolin","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Natural and Applied Science, Duke Kunshan University , No. 8 Duke Ave., Kunshan, Jiangsu 215316 , China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Siyu","family":"Zou","sequence":"additional","affiliation":[{"name":"Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health , 615 N. Wolfe Street, Baltimore, MD 21205 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Frank","family":"Qian","sequence":"additional","affiliation":[{"name":"Department of Medicine , Beth Israel Deaconess Medical Center, , Boston, MA , USA"},{"name":"Harvard Medical School , Beth Israel Deaconess Medical Center, , Boston, MA , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Zheng","sequence":"additional","affiliation":[{"name":"Department of Radiology, University of Cambridge , Cambridge CB2 0QQ , UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angela Y","family":"Xiao","sequence":"additional","affiliation":[{"name":"Department of International Studies, Macalester College , 1600 Grand Avenue St. Paul, St Paul, MN 55105 , USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6657-6940","authenticated-orcid":false,"given":"Xiuhua","family":"Guo","sequence":"additional","affiliation":[{"name":"Beijing Municipal Key Laboratory of Clinical Epidemiology, Capital Medical University , Beijing , China"},{"name":"Department of Epidemiology and Health Statistics , School of Public Health, , Beijing , China"},{"name":"Capital Medical University , School of Public Health, , Beijing , China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2024,1,20]]},"reference":[{"key":"2024012211350867600_ref1","doi-asserted-by":"crossref","first-page":"58","DOI":"10.1016\/j.puhe.2022.08.018","article-title":"The effect of incontinence on depression among older adults: a longitudinal study in China","volume":"212","author":"Zhang","year":"2022","journal-title":"Public Health"},{"key":"2024012211350867600_ref2","first-page":"38","article-title":"Incontinence in frail elderly persons: report of the 6th International Consultation on Incontinence","volume":"40","author":"Gibson","year":"2021","journal-title":"NeurourolUrodyn"},{"key":"2024012211350867600_ref3","doi-asserted-by":"crossref","first-page":"44","DOI":"10.1016\/j.mpmed.2020.10.012","article-title":"Urinary and faecal incontinence in older adults","volume":"49","author":"Shaw","year":"2021","journal-title":"Medicine"},{"key":"2024012211350867600_ref4","doi-asserted-by":"crossref","first-page":"7","DOI":"10.1016\/S0140-6736(12)60482-6","article-title":"Multimorbidity: redesigning health care for people who use it","volume":"380","author":"Salisbury","year":"2012","journal-title":"Lancet"},{"key":"2024012211350867600_ref5","first-page":"1745","article-title":"Multimorbidity associated with urinary incontinence among older women and men with complex needs in Aotearoa | New Zealand","volume":"42","author":"Schluter","year":"2023","journal-title":"NeurourolUrodyn"},{"key":"2024012211350867600_ref6","first-page":"62","article-title":"Prevalence of urinary incontinence and its association with multimorbidity in women aged 50 years or older: a population-based study","volume":"35","author":"Reigota","year":"2016","journal-title":"NeurourolUrodyn"},{"key":"2024012211350867600_ref7","doi-asserted-by":"crossref","first-page":"e71","DOI":"10.3399\/bjgp20X713921","article-title":"Association of multimorbidity with higher levels of urinary incontinence: a cross-sectional study of 23 089 individuals aged \u226515 years residing in Spain","volume":"71","author":"Jacob","year":"2021","journal-title":"Br J Gen Pract"},{"key":"2024012211350867600_ref8","doi-asserted-by":"crossref","first-page":"2038","DOI":"10.1093\/ageing\/afab151","article-title":"Physical multimorbidity and incident urinary incontinence among community-dwelling adults aged \u226550 years: findings from a prospective analysis of the Irish Longitudinal Study on Ageing","volume":"50","author":"Smith","year":"2021","journal-title":"Age Ageing"},{"key":"2024012211350867600_ref9","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.maturitas.2022.12.007","article-title":"Multimorbidity increased the risk of urinary incontinence in community-dwelling adults: results from the English Longitudinal Study on Ageing","volume":"169","author":"Barbagallo","year":"2023","journal-title":"Maturitas"},{"key":"2024012211350867600_ref10","doi-asserted-by":"crossref","first-page":"101860","DOI":"10.1016\/j.eclinm.2023.101860","article-title":"Global and regional prevalence of multimorbidity in the adult population in community settings: a systematic review and meta-analysis","volume":"57","author":"Chowdhury","year":"2023","journal-title":"EClinicalMedicine"},{"key":"2024012211350867600_ref11","doi-asserted-by":"crossref","first-page":"1821","DOI":"10.1016\/S0140-6736(22)02410-2","article-title":"Population ageing in China: crisis or opportunity?","volume":"400","author":"The Lancet","year":"2022","journal-title":"Lancet"},{"key":"2024012211350867600_ref12","doi-asserted-by":"crossref","first-page":"61","DOI":"10.1093\/ije\/dys203","article-title":"Cohort profile: the China Health and Retirement Longitudinal Study (CHARLS)","volume":"43","author":"Zhao","year":"2014","journal-title":"Int J Epidemiol"},{"key":"2024012211350867600_ref13","doi-asserted-by":"crossref","first-page":"e840","DOI":"10.1016\/S2214-109X(20)30127-3","article-title":"Physical multimorbidity, health service use, and catastrophic health expenditure by socioeconomic groups in China: an analysis of population-based panel data","volume":"8","author":"Zhao","year":"2020","journal-title":"Lancet Glob Health"},{"key":"2024012211350867600_ref14","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1016\/S0140-6736(03)15268-3","article-title":"Appropriate body-mass index for Asian populations and its implications for policy and intervention strategies","volume":"363","author":"WHO Expert Consultation","year":"2004","journal-title":"Lancet"},{"key":"2024012211350867600_ref15","doi-asserted-by":"crossref","first-page":"k757","DOI":"10.1136\/bmj.k757","article-title":"Population attributable fraction","volume":"360","author":"Mansournia","year":"2018","journal-title":"BMJ"},{"key":"2024012211350867600_ref16","doi-asserted-by":"crossref","first-page":"420","DOI":"10.1177\/1536867X1101100306","article-title":"Comparing coefficients of nested nonlinear probability models","volume":"11","author":"Kohler","year":"2011","journal-title":"Stata J"},{"key":"2024012211350867600_ref17","doi-asserted-by":"crossref","first-page":"857","DOI":"10.1007\/s00192-019-04058-w","article-title":"Urinary incontinence and cardiovascular disease: a narrative review","volume":"31","author":"John","year":"2020","journal-title":"Int Urogynecol J"},{"key":"2024012211350867600_ref18","doi-asserted-by":"crossref","first-page":"489","DOI":"10.2340\/16501977-0354","article-title":"Prevalence of incontinence in patients after stroke during rehabilitation: a multi-centre study","volume":"41","author":"Kovindha","year":"2009","journal-title":"J Rehabil Med"},{"key":"2024012211350867600_ref19","first-page":"362","article-title":"What characteristics predispose to continence in nursing home residents?: a population-based cross-sectional study","volume":"34","author":"Saga","year":"2015","journal-title":"NeurourolUrodyn"},{"key":"2024012211350867600_ref20","doi-asserted-by":"crossref","first-page":"1407","DOI":"10.1007\/s40520-021-02046-z","article-title":"Factors associated with urinary and double incontinence in a geriatric post-hip fracture assessment in older women","volume":"34","author":"Hellman-Bronstein","year":"2022","journal-title":"Aging Clin Exp Res"},{"key":"2024012211350867600_ref21","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1007\/s00192-017-3365-9","article-title":"Female double incontinence: prevalence, incidence, and risk factors from the SABE (Health, Wellbeing and Aging) study","volume":"29","author":"Yuaso","year":"2018","journal-title":"Int Urogynecol J"},{"key":"2024012211350867600_ref22","first-page":"211","article-title":"Symptoms of urinary and faecal incontinence among men and women 75+ in relations to health complaints and quality of life","volume":"23","author":"Stenzelius","year":"2004","journal-title":"NeurourolUrodyn"},{"key":"2024012211350867600_ref23","doi-asserted-by":"crossref","first-page":"352","DOI":"10.1097\/01.AOG.0000109520.27286.84","article-title":"Prevalence and severity of urinary incontinence in kidney transplant recipients","volume":"103","author":"Heit","year":"2004","journal-title":"Obstet Gynecol"},{"key":"2024012211350867600_ref24","doi-asserted-by":"crossref","first-page":"292","DOI":"10.1002\/lt.24684","article-title":"Disability in patients with end-stage liver disease: results from the functional assessment in liver transplantation study","volume":"23","author":"Samoylova","year":"2017","journal-title":"Liver Transpl"},{"key":"2024012211350867600_ref25","doi-asserted-by":"crossref","first-page":"555","DOI":"10.1002\/hep.22913","article-title":"Alterations in the functional capacity of albumin in patients with decompensated cirrhosis is associated with increased mortality","volume":"50","author":"Jalan","year":"2009","journal-title":"Hepatology"},{"key":"2024012211350867600_ref26","doi-asserted-by":"crossref","first-page":"2838","DOI":"10.3390\/jcm10132838","article-title":"Diagnostic potential of low serum platelet, albumin and prolong PT-INR for overactive bladder and nocturia in chronic hepatitis-related liver cirrhosis","volume":"10","author":"Chuang","year":"2021","journal-title":"J Clin Med"},{"key":"2024012211350867600_ref27","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1007\/s40520-017-0723-x","article-title":"Prevalence of fecal incontinence and associated risk factors in elderly outpatients: a cross-sectional study","volume":"29","author":"Demir","year":"2017","journal-title":"Aging Clin Exp Res"},{"key":"2024012211350867600_ref28","doi-asserted-by":"crossref","first-page":"1321","DOI":"10.1007\/s11255-016-1304-1","article-title":"Urinary incontinence and diuretic avoidance among adults with chronic kidney disease","volume":"48","author":"Patel","year":"2016","journal-title":"Int Urol Nephrol"},{"key":"2024012211350867600_ref29","doi-asserted-by":"crossref","first-page":"93","DOI":"10.1007\/s40266-013-0145-1","article-title":"Managing therapeutic competition in patients with heart failure, lower urinary tract symptoms and incontinence","volume":"31","author":"Tannenbaum","year":"2014","journal-title":"Drugs Aging"},{"key":"2024012211350867600_ref30","doi-asserted-by":"crossref","first-page":"57","DOI":"10.1186\/1471-2318-13-57","article-title":"Prevalence of commonly prescribed medications potentially contributing to urinary symptoms in a cohort of older patients seeking care for incontinence","volume":"13","author":"Kashyap","year":"2013","journal-title":"BMC Geriatr"},{"key":"2024012211350867600_ref31","doi-asserted-by":"crossref","first-page":"974","DOI":"10.1093\/ageing\/afaa054","article-title":"Transitions between frailty states in the very old: the influence of socioeconomic status and multi-morbidity in the Newcastle 85+ cohort study","volume":"49","author":"Mendon\u00e7a","year":"2020","journal-title":"Age Ageing"},{"key":"2024012211350867600_ref32","doi-asserted-by":"crossref","first-page":"2183","DOI":"10.1093\/ageing\/afab138","article-title":"Multimorbidity patterns and risk of frailty in older community-dwelling adults: a population-based cohort study","volume":"50","author":"Tazzeo","year":"2021","journal-title":"Age Ageing"},{"key":"2024012211350867600_ref33","doi-asserted-by":"crossref","first-page":"M146","DOI":"10.1093\/gerona\/56.3.M146","article-title":"Frailty in older adults: evidence for a phenotype","volume":"56","author":"Fried","year":"2001","journal-title":"J Gerontol A"},{"key":"2024012211350867600_ref34","doi-asserted-by":"crossref","first-page":"M19","DOI":"10.1093\/gerona\/56.1.M19","article-title":"New-onset incontinence and markers of frailty: data from the Hispanic Established Populations for Epidemiologic Studies of the Elderly","volume":"56","author":"Miles","year":"2001","journal-title":"J Gerontol A Biol Sci Med Sci"},{"key":"2024012211350867600_ref35","doi-asserted-by":"crossref","first-page":"149","DOI":"10.1177\/01640275221087612","article-title":"The relationship between multimorbidity and types of chronic diseases and self-rated memory","volume":"45","author":"Franco","year":"2023","journal-title":"Res Aging"},{"key":"2024012211350867600_ref36","doi-asserted-by":"crossref","first-page":"298","DOI":"10.1016\/j.archger.2011.05.021","article-title":"Memory complaints in the elderly: quality of life and daily living activities. A population based study","volume":"54","author":"Montejo","year":"2012","journal-title":"Arch Gerontol Geriatr"},{"key":"2024012211350867600_ref37","doi-asserted-by":"crossref","first-page":"19","DOI":"10.1080\/09638288.2017.1370729","article-title":"Beyond memory problems: multiple obstacles to health and quality of life in older people seeking help for subjective memory complaints","volume":"41","author":"Rotenberg Shpigelman","year":"2019","journal-title":"Disabil Rehabil"},{"key":"2024012211350867600_ref38","doi-asserted-by":"crossref","first-page":"36","DOI":"10.1016\/j.jad.2017.06.009","article-title":"Multimorbidity and depression: a systematic review and meta-analysis","volume":"221","author":"Read","year":"2017","journal-title":"J Affect Disord"},{"key":"2024012211350867600_ref39","doi-asserted-by":"crossref","first-page":"e063729","DOI":"10.1136\/bmjopen-2022-063729","article-title":"Multimorbidity patterns and the relation to self-rated health among older Japanese people: a nationwide cross-sectional study","volume":"12","author":"Honda","year":"2022","journal-title":"BMJ Open"},{"key":"2024012211350867600_ref40","doi-asserted-by":"crossref","first-page":"393","DOI":"10.1097\/GCO.0000000000000094","article-title":"Risk factors for urinary, fecal, or double incontinence in women","volume":"26","author":"Matthews","year":"2014","journal-title":"Curr Opin Obstet Gynecol"},{"key":"2024012211350867600_ref41","doi-asserted-by":"crossref","first-page":"848","DOI":"10.1016\/j.juro.2018.04.076","article-title":"Mental health, sleep, and physical function in treatment-seeking women with urinary incontinence","volume":"200","author":"Siddiqui","year":"2018","journal-title":"J Urol"},{"key":"2024012211350867600_ref42","doi-asserted-by":"crossref","first-page":"145","DOI":"10.1177\/14034948980260020301","article-title":"Examining what self-rated health question is understood to mean by respondents","volume":"26","author":"Manderbacka","year":"1998","journal-title":"Scand J Soc Med"}],"container-title":["Age and Ageing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/ageing\/article-pdf\/53\/1\/afad258\/56315829\/afad258.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/ageing\/article-pdf\/53\/1\/afad258\/56315829\/afad258.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,1,22]],"date-time":"2024-01-22T11:35:42Z","timestamp":1705923342000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/ageing\/article\/doi\/10.1093\/ageing\/afad258\/7584452"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,1,1]]},"references-count":42,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2024,1,2]]}},"URL":"https:\/\/doi.org\/10.1093\/ageing\/afad258","relation":{},"ISSN":["0002-0729","1468-2834"],"issn-type":[{"value":"0002-0729","type":"print"},{"value":"1468-2834","type":"electronic"}],"subject":[],"published-other":{"date-parts":[[2024,1,1]]},"published":{"date-parts":[[2024,1,1]]},"article-number":"afad258"}}