Protocol - Urinary Incontinence

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Protocol Name from Source:

Urinary History


Publicly available


An interview-administered four-item questionnaire measuring urine leakage, use of protection for urine leakage, and impact of leakage of urine on daily activities.


1. In the past 12 months, how often have you leaked urine? 

[ ] 0 less than once per month

[ ] 1 one or more times per month

[ ] 2 one or more times per week

[ ] 3 Every day

[ ] 8 Don't know

2. In the past 12 months, when does your leakage usually occur? 

(Interviewer note: OPTIONAL)

[ ] 1 With an activity like coughing, lifting, standing up or exercise

[ ] 2 When you have the urge to urinate and can't get to a toilet fast enough

[ ] 3 You leak urine unrelated to coughing, sneezing, lifting or urge

[ ] 8 Don't know

[ ] 7 Refused

3. Do you wear any protection for when you leak urine? 

[ ] 1 Yes (if yes, go to 3b)

[ ] 2 No

[ ] 8 Don't know

[ ] 7 Refused

3b. During a typical day, how many times, on average, do you change your protection because it is wet?

[ ] 0 None

[ ] 1 Once

[ ] 2 2 to 3 times

[ ] 3 4 or more times

[ ] 8 Don't know

4. How much does the leakage of urine interfere with your daily activities (such as work, exercise, shopping, or recreational activities)? Would you say┬┐.

[ ] 1 Not at all

[ ] 2 Mildly

[ ] 3 Moderately

[ ] 4 Severely

[ ] 8 Don't know

Personnel and Training Required

The interviewer must be trained to conduct personal interviews with individuals from the general population. The interviewer must be trained and found to be competent (i.e., tested by an expert) at the completion of personal interviews. The interviewer should be trained to prompt respondents further if a "don't know" response is provided."

Equipment Needs

The PhenX Working Group acknowledges that these questions can be administered in a computerized or noncomputerized format (i.e., paper-and-pencil instrument). Computer software is necessary to develop computer-assisted instruments. The interviewer will require a laptop computer/handheld computer to administer a computer-assisted questionnaire


Requirement CategoryRequired
Average time of greater than 15 minutes in an unaffected individualNo
Major equipmentNo
Specialized requirements for biospecimen collectionNo
Specialized trainingNo

Mode of Administration

Life Stage:

Adult, Senior

Specific Instructions:

Although the original Health, Aging, and Body Composition Study was conducted in the geriatric population, the PhenX Geriatrics Working Group acknowledges this protocol may be used with other adult populations.

Research Domain Information

Release Date:

July 2, 2018


A questionnaire assessing urinary leakage in the past 12 months.


It is important to address urinary incontinence, as it is a symptom that can be caused by problems in the urinary tract or by underlying medical or physical problems. It can potentially cause additional complications, including skin problems and urinary tract infections. Risk factors include gender, age, being overweight, smoking, a family history of urinary incontinence, diabetes, and additional neurological diseases. Urinary incontinence can be stigmatizing and lead to limitations in daily activities.

Selection Rationale

The Health, Aging and Body Composition Study questions were used on a large population of biracial older adult women.





Process and Review

The Expert Review Panel has yet to review this measure.


The Health, Aging and Body Composition Study questions were used on a large population of biracial older adult women.

General References

Jackson, R. A., Vittinghoff, E., Kanaya, A. M., Miles, T. P., Resnick, H. E., Kritchevsky, S. B., ... Brown, J. S. (2004). Urinary incontinence in elderly women: Findings from the Health, Aging, and Body Composition Study. Obstetrics & Gynecology, 104,301-307.

Peron, E. P., Zheng, Y., Perera, S., Newman, A. B., Resnick, N. M., Shorr, R. I., ... Ruby, C. M. (2012).  Antihypertensive drug class use and differential risk of urinary incontinence in community-dwelling older women. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences  67,1373-1378.

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