How does the onset of incontinence affect satisfaction with life among older women and men? Findings from a nationally representative longitudinal study (German Ageing Survey)

BACKGROUND: There is a large body of evidence showing that incontinence is associated with decreased health-related quality of life (HRQoL). Moreover, while a few cross-sectional studies have shown that incontinence is associated with decreased life satisfaction, there is a lack of studies regarding whether the onset of incontinence influences life satisfaction of affected individuals longitudinally. Thus, the objective of this study is: (i) to investigate the impact of incontinence on life satisfaction and (ii) whether this effect differed between women and men using a large population-based sample longitudinally.

METHODS: Longitudinal data from 2008 to 2014 were retrieved from a nationally representative sample (9869 observations in regression analysis) of community-dwelling individuals aged 40 years and over (German Ageing Survey, DEAS). Physician-diagnosed incontinence was reported by respondents. Life satisfaction was quantified using the well-established Satisfaction with Life Scale. Linear fixed-effects regressions were used.

RESULTS: After adjusting for potential confounders (e.g., self-rated health or depression), regressions revealed that the onset of incontinence was associated with a decline in life satisfaction in men (β = -.25, p < .01), but not in the total sample and in women. These differences were significant (p < .05). In a further sensitivity analysis, individuals with cancer were excluded. However, in terms of significance and effect size, the impact of incontinence on life satisfaction in men remained almost the same in both models.

CONCLUSIONS: The onset of incontinence markedly reduces life satisfaction among men aged 40 and over. Interventional strategies to postpone incontinence may assist in maintaining life satisfaction in men.