Am J Epidemiol 2003; 157:834-842.
Copyright © 2003 by Johns
Hopkins Bloomberg School of Public Health
ORIGINAL CONTRIBUTIONS |
Developmental Typology of Trajectories to Nighttime Bladder Control: Epidemiologic Application of Longitudinal Latent Class Analysis
1 Department of Psychiatry, University of Cambridge, Addenbrooke’s Hospital, Cambridge CB2 2QQ, United Kingdom.
2 Department of Epidemiology and Public Health, Faculty of Medicine, Imperial College of Science, Technology, and Medicine, London SW7 2AZ, United Kingdom.
3 MRC National Survey of Health and Development, University College London, London WC1E 6BT, United Kingdom.
The authors aimed to characterize developmental trajectories to nighttime continence by applying two latent class models—longitudinal latent class analysis (LLCA) and latent class growth analysis (LCGA)—to data on nighttime bed-wetting from a population-based birth cohort, the Medical Research Council 1946 National Survey of Health and Development cohort. Data on a binary outcome (wetting in the past month vs. not wetting) were available for children at six ages (4, 6, 8, 9, 11, and 15 years) assessed in 1950, 1952, 1954, 1955, 1957, and 1961. For 3,272 children with complete data (62.5% of the cohort), results of sequential model comparisons (T classes vs. T + 1 classes) and chi-square goodness-of-fit tests were evaluated using parametric bootstrapping. At least four trajectory classes (LLCA and LCGA) were identified. Associations between class membership and the prevalence of related measures were examined using a confirmatory latent class analysis approach. Inclusion of 1,483 children with partially incomplete data (n = 4,755; 90.9% of the cohort) enabled the authors to refine trajectories further: normal development (prevalence = 84.0%); delayed acquisition of bladder control ("transient" (8.7%) and "persistent" (1.8%)), capturing primary enuresis; chronic bed-wetting (2.6%), or experiencing night wetting until age 15 years; and a final trajectory (relapse = 2.9%) capturing secondary or onset enuresis. This empirically based, typologic approach to analysis of extensive longitudinal data in a general population sample provides an alternative perspective to that offered by traditional diagnostic criteria.
bladder; child development; enuresis; missing data; models, statistical; prevalence; prospective studies; repeated measures
Abbreviations: Abbreviations: AIC, Akaike’s Information Criterion; BIC, Bayesian Information Criterion; LCGA, latent class growth analysis; LLCA, longitudinal latent class analysis.
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