Xiyin Chen

Objectives: Urinary incontinence (UI) significantly deteriorates the quality of life in the elderly, with a disproportionately higher burden among women. With populations aging in the USA and the UK, understanding the gender‐specific prevalence, determinants, and future care needs in UI is critical for shaping gender‐responsive health policies and care strategies. Methods: Data from the Health and Retirement Study (HRS, 2010–2020) and the English Longitudinal Study of Aging (ELSA, 2009–2019) involving participants aged 50 and older were analyzed. UI was assessed through self‐reported urinary leakage during the last 12 months. The prevalence, determinants, and future care needs were estimated by gender. Results: The analysis included 111,049 and 52,972 observations from HRS and ELSA, respectively. The findings revealed a steady increase in UI prevalence during the 2010s in males (HRS 11.2%–15.1%, ELSA 7.2%–12.0%) and females (HRS 31.4%–36.3%, ELSA 21.0%–28.1%). Contributory factors included aging, higher education levels, and comorbidities. Projections indicate a rise in UI‐related care needs in the USA (HRS Female: from 22.1 to 25.7 million, Male: from 7.8 to 9.8 million) and the UK (ELSA Female: from 3.6 to 4.2 million, Male: from 1.4 to 1.6 million) during the 2020s, with women accounting for 65% of this growth, among which the fastest growth was among those aged 80 and over. Conclusions: The rising prevalence of UI, particularly among women, alongside population aging in the USA and UK necessitates an escalation in gender‐responsive expansion of care services. Gender‐sensitive counseling on tailored prevention strategies and care services such as weight loss and Kegel exercises should be provided to support quality of life and healthy aging, especially in women.

Background: Little is known about the relationship between syndromes in Traditional Chinese Medicine (TCM) and chronic diseases coded by Western Medicine (WM). TCM hospitals where both WM and TCM are practiced offer an opportunity to assess this relationship. TCM, based on syndrome differentiation and treatment, may aid in guiding treatment and predicting length of stay and healthcare costs. However, inconsistent coding of TCM syndromes arises due to variations in diagnostic interpretation, subjective assessment, and lack of standardized coding practices. The objective was to assess the correlation between WM diagnoses and TCM syndromes, accounting for diagnostic miscoding in the data. Methods: We examined discharge data from 1,218,224 records for patients aged 45 and above, diagnosed with cardiometabolic diseases and admitted to TCM hospitals between 2017 and 2022, stays ranging from 24-hours to 90 days. Latent class analysis (LCA) was used to measure the correlation between TCM syndromes and WM. To address potential diagnostic errors, we applied bivariate probit models with instrumental variable (IV). Results: There were 580,698 (47.67%) records for males, while 989,702 (81.24%) records from Tertiary-A hospitals. The LCA and probit models revealed that TCM syndrome diagnoses had a high ratio of noise to signal. After correcting for diagnostic errors, significant associations were found between WM diagnoses and TCM syndromes. Notably, diabetes mellitus was strongly associated with syndrome/pattern of qi and yin deficiency (coefficient = 2.711); cerebrovascular diseases showed strong associations with syndrome/pattern of qi deficiency with blood stasis (coefficient = 2.433) and syndrome/pattern of wind and phlegm blocking collaterals (coefficient = 3.176). All patterns had strong marginal effects (P < 0.001). Conclusion: This large-scale study quantitatively maps the relationship between TCM and WM diagnoses. It introduces a new statistical approach to understanding the correlation between these two diagnostic systems, offering insights into integrated medicine for secondary prevention.