Factors Influencing the Severity of Urinary and Defecatory Dysfunction Among the Middle-Aged and Older Adult Chinese Population: Longitudinal Study of a 5-Wave Survey Cohort

Abstract Background Urinary and defecatory dysfunction (UDD) is a significant concern among the aging population in China. However, there is a lack of longitudinal research exploring the risk factors of UDD severity in Chinese older adults. Objective This study uses data from the China Health and Retirement Longitudinal Study spanning 2011 to 2020 to explore UDD risk factors in the middle-aged and older adult Chinese population, focusing on epidemiological characteristics and potential influences on severity. Methods A longitudinal cohort of over 10,000 participants from the China Health and Retirement Longitudinal Study was analyzed across 5 waves using Bayesian logistic regression. This analysis examined associations between UDD severity and factors including demographic, lifestyle, and health-related factors, including comorbidities, BMI, and handgrip strength. Results Higher UDD prevalence was observed among female population, older adults, those with low education levels, and rural residents. Depression, arthritis, and low handgrip strength emerged as critical predictors of severe UDD. Additionally, abnormal BMI, both underweight (odds ratio [OR] 3.019, 95% CI 1.484‐5.951; P =0.002) and obesity (OR 2.697, 95% CI 1.338‐5.217; P =0.005), was strongly linked to increased severity and persistence of UDD. Participants aged 66 years and older exhibited the highest UDD prevalence, with both underweight and obese individuals facing the greatest risk of persistent and worsening symptoms. Conclusions This study is the first to longitudinally examine the risk factors of UDD severity in China’s middle-aging and aging population. The findings underscore the need for targeted interventions focusing on muscle strength rehabilitation and comorbidity management to mitigate UDD progression, contributing to improved quality of life for older individuals.