Longitudinal associations of objectively measured sedentary behaviour and physical activity intensities with urinary incontinence among middle-aged women: a cohort study

Abstract Background Urinary incontinence is a prevalent condition among middle-aged women, yet its relationship with activity behaviours remains underexplored. This study aimed to explore the longitudinal associations between objectively measured sedentary behaviour and physical activity intensities with urinary incontinence and its types in middle-aged Finnish women. Methods A total of 224 women aged 47–55 years at baseline, drawn from the ERMA and EsmiRs studies were included. The prevalence of stress, urgency and mixed urinary incontinence symptoms was assessed using a structured questionnaire. Sedentary behaviour and physical activity were objectively measured using hip-worn accelerometers at baseline and at 4-year follow-up. Logistic generalized estimating equation models were used to analyse the associations between sedentary behaviour and different physical activity intensities with urinary incontinence, adjusting for potential confounders. Results Higher light-intensity physical activity was associated with slightly increased odds of urinary incontinence (OR = 1.004, 95% CI: 1.000 to 1.008, p = 0.043), specifically stress urinary incontinence (OR = 1.007, 95% CI: 1.002 to 1.0011, p = 0.002). Sedentary behaviour showed an inverse relationship with urinary incontinence and stress urinary incontinence that disappeared when accounting for all activity behaviours. No significant associations were observed for moderate or vigorous physical activity. Conclusions No consistent harmful or beneficial associations of physical activity or sedentary behaviour with urinary incontinence were found in middle-aged women. The marginal link between light physical activity and stress urinary incontinence may reflect behavioural adaptations among symptomatic women. Future research should investigate how the type of physical behaviour, rather than its intensity, and long-term activity patterns, as opposed to short- or medium-term, may influence urinary incontinence in this population.