Bidirectional Associations Between Urinary Incontinence and Poor Mental Health Among Middle-Aged and Older Adults in Thailand

Background/Purpose: In a longitudinal study of ageing adults in Thailand, the goal of the research was to evaluate the bidirectional relationships between urinary incontinence (UI) and poor mental health indicators. Methods: We analyzed prospective cohort data of participants 45 years and older from three consecutive waves in 2015, 2017, and in 2020 of the Health, Aging and Retirement in Thailand (HART) study. UI and poor mental health indicators were assessed by self-report. We used logistic regression analysis to evaluate the longitudinal relationships between measures of UI and poor mental health indicators from 2015 (baseline), 2017 (first follow-up), and 2020 (second follow-up). Results: UI in one and 2–3 survey waves were positively associated with incident depressive symptoms, and depressive symptoms in one and 2–3 waves were positively associated with incident UI. UI in one and 2–3 waves were positively associated with incident insomnia symptoms, and insomnia symptoms in one and 2–3 waves were positively associated with incident UI. UI in one and 2–3 waves were positively associated with incident loneliness, and loneliness in one and 2–3 waves were positively associated with incident UI. UI in one wave was positively associated with poor QoL/happiness, and poor QoL/happiness in 2–3 waves was positively associated with incident UI. UI in one and 2–3 waves were not significantly associated with incident poor mental health, and poor mental health in one and 2–3 waves were positively associated with incident UI. Conclusion: We found bidirectional associations between UI and poor mental health. In Thailand, screening for both UI and poor mental health is recommended for older adults.