Social Isolation and Urgency Urinary Incontinence Among Older Women in the United States: The Modifying Effect of Anxiety and Depression

Purpose: To examine associations between social isolation and urgency urinary incontinence (UUI) among older women and evaluate anxiety or depression as modifiers. Method: We conducted a cross-sectional study of women aged ≥65 years in two National Health and Nutrition Examination Survey cycles (2015 to 2016 and 2017 to 2018). UUI was defined as leakage in the past year with an urge to urinate. Social isolation was measured using a four-item index and categorized as none , low , or high . Anxiety was defined as feeling worried/nervous at least once per month, and depression as a Patient Health Questionnaire-9 score ≥5. We used survey-weighted logistic regression. Results: Among 1,126 older women, 54.1% reported UUI, 42.2% anxiety, and 26.4% depression. Compared to no social isolation, high social isolation was associated with greater odds of UUI (adjusted odds ratio = 1.54, 95% confidence interval [1.02, 2.33], p = .045). Depression ( p = .001) was significantly associated with UUI. Depression (p interaction = .067) and anxiety (p interaction = .302) were not significant modifiers. Conclusion: Findings underscore the need for psychosocial screening and integrated support for older women with UUI.