Urinary incontinence (UI) significantly deteriorates the quality of life in the elderly, with a disproportionately higher burden among women. With populations aging in the USA and the UK, understanding the gender-specific prevalence, determinants, and future care needs in UI is critical for shaping gender-responsive health policies and care strategies.
Data from the Health and Retirement Study (HRS, 2010-2020) and the English Longitudinal Study of Aging (ELSA, 2009-2019) involving participants aged 50 and older were analyzed. UI was assessed through self-reported urinary leakage during the last 12 months. The prevalence, determinants, and future care needs were estimated by gender.
The analysis included 111,049 and 52,972 observations from HRS and ELSA, respectively. The findings revealed a steady increase in UI prevalence during the 2010s in males (HRS 11.2%-15.1%, ELSA 7.2%-12.0%) and females (HRS 31.4%-36.3%, ELSA 21.0%-28.1%). Contributory factors included aging, higher education levels, and comorbidities. Projections indicate a rise in UI-related care needs in the USA (HRS Female: from 22.1 to 25.7 million, Male: from 7.8 to 9.8 million) and the UK (ELSA Female: from 3.6 to 4.2 million, Male: from 1.4 to 1.6 million) during the 2020s, with women accounting for 65% of this growth, among which the fastest growth was among those aged 80 and over.
The rising prevalence of UI, particularly among women, alongside population aging in the USA and UK necessitates an escalation in gender-responsive expansion of care services. Gender-sensitive counseling on tailored prevention strategies and care services such as weight loss and Kegel exercises should be provided to support quality of life and healthy aging, especially in women.
Aging medicine (Milton (N.S.W)). 2026 May 03*** epublish ***
Xiyin Chen, Shaoxiang Jiang, Muqi Guo, Hao Zhang, Mouwang Zhou, Yao Yao
School of Public Health, LKS Faculty of Medicine The University of Hong Kong Hong Kong SAR China., Institute for Global Health and Development Peking University Beijing China., Harvard T.H. Chan School of Public Health Boston Massachusetts USA., Department of Health Policy and Organization University of Alabama at Birmingham Birmingham Alabama USA., Department of Rehabilitation Medicine Peking University Third Hospital Beijing China., China Center for Health Development Studies Peking University Beijing China.