{
  "abstract": "Objectives This study aimed to investigate the longitudinal association between sleep disturbance and the risk of new-onset incontinence in middle-aged and older Chinese adults and to explore whether chronic lung diseases mediate this relationship.Design A prospective cohort study based on a nationally representative survey.Setting Data were obtained from the China Health and Retirement Longitudinal Study, a national survey of middle-aged and elderly community-dwelling Chinese adults.Participants A total of 7098 participants aged ≥50 years who were continent at baseline in 2011 and completed follow-up in 2015 were included in the analysis.Measures Sleep disturbance was assessed via self-report and categorised into good versus poor quality. Incident incontinence was defined as a new onset of difficulty in controlling urination or defecation. Multivariable logistic regression models were used to estimate the association between baseline sleep disturbance and incident incontinence, adjusting for sociodemographic, behavioural and health-related covariates. Mediation analysis was conducted to evaluate the indirect role of chronic lung disease in the sleep–incontinence pathway. Subgroup and interaction analyses assessed whether key demographic or health factors influenced the sleep–incontinence association.Results Sleep disturbance at baseline was significantly associated with a higher risk of developing incontinence over 4 years (adjusted OR 1.34, p=0.040). This association remained robust across subgroups, particularly among participants aged ≥65 years, rural residents, those with higher education and those with chronic lung disease. Mediation analysis revealed that chronic lung disease partially mediated the relationship between sleep disturbance and incontinence, accounting for 7.59% of the total effect (indirect effect: 0.00104, 95% CI 0.00012 to 0.00170). Subgroup and interaction analyses confirmed the consistency of the findings across various demographic and health strata.Conclusion Sleep disturbance was associated with higher odds of incident incontinence among middle-aged and older Chinese adults. Chronic lung disease contributed modestly to this association. These findings underscore the potential importance of sleep health and comorbidity management in continence care for ageing populations.",
  "authors": [
    {
      "affiliations": [
        "The First People’s Hospital of Huzhou, Huzhou, Zhejiang, China"
      ],
      "name": "Yuefan Shen"
    },
    {
      "affiliations": [
        "The First People’s Hospital of Huzhou, Huzhou, Zhejiang, China"
      ],
      "name": "Weixin Zhang"
    },
    {
      "affiliations": [
        "The First People’s Hospital of Huzhou, Huzhou, Zhejiang, China"
      ],
      "name": "Jianguo Gao"
    },
    {
      "affiliations": [
        "The First People’s Hospital of Huzhou, Huzhou, Zhejiang, China"
      ],
      "name": "Sihai Shao"
    }
  ],
  "title": "Sleep disturbance and risk of incident incontinence in middle-aged and older Chinese adults: a 4-year national cohort study",
  "uid": "37c9996a-2465-56cc-af62-35277c42455b"
}