Sarcopenic Obesity, Not Sarcopenia or Obesity Alone, Is Independently Associated With Urinary Incontinence in Older Women

BACKGROUND: Sarcopenic obesity is a condition characterized by decreased muscle mass and strength along with an increased body fat percentage. While previous studies have separately examined the relationship between sarcopenia and obesity with urinary incontinence (UI), this study aimed to evaluate the combined impact of sarcopenic obesity on UI. METHODS: This study included 1147 female patients aged ≥ 60 years who attended a geriatrics outpatient clinic between November 2012 and June 2024. Body composition was assessed using bioimpedance analysis (BIA), and muscle strength was measured by handgrip strength. The skeletal muscle mass index (SMMI) was adjusted for body weight. Sarcopenic obesity was defined using population-specific threshold values, incorporating low muscle strength, low muscle mass, and high fat percentage. Patients were classified into four groups: non-sarcopenic non-obese, sarcopenic non-obese, sarcopenic obese, and non-sarcopenic obese. The prevalence of UI and its association with these phenotypes was analyzed using multivariable logistic regression. RESULTS: The mean age was 74 ± 7 years. The prevalence of sarcopenic obesity was 20%, while the prevalence of UI was 49%. UI was observed in 57% of the 230 patients with sarcopenic obesity. A significant difference in UI prevalence was found among phenotypic groups (p < 0.001). In multivariable regression analysis, sarcopenic obesity was independently associated with UI (OR: 1.82, 95% CI: 1.16-2.85, p = 0.009). Other phenotypes were not significantly associated. CONCLUSIONS: Sarcopenic obesity is more strongly associated with UI than sarcopenia or obesity alone. Early identification and targeted interventions may play a crucial role in mitigating the effects of UI or reducing its incidence.