Journal Article

Developmental Typology of Trajectories to Nighttime Bladder Control: Epidemiologic Application of Longitudinal Latent Class Analysis

Tim J. Croudace, Marjo-Riitta Jarvelin, Michael E. J. Wadsworth and Peter B. Jones

in American Journal of Epidemiology

Published on behalf of Johns Hopkins Bloomberg School of Public Health

Volume 157, issue 9, pages 834-842
Published in print May 2003 | ISSN: 0002-9262
Published online May 2003 | e-ISSN: 1476-6256 | DOI: http://dx.doi.org/10.1093/aje/kwg049
Developmental Typology of Trajectories to Nighttime Bladder Control: Epidemiologic Application of Longitudinal Latent Class Analysis

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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.

Keywords: bladder; child development; enuresis; missing data; models, statistical; prevalence; prospective studies; repeated measures; Abbreviations: AIC, Akaike’s Information Criterion; BIC, Bayesian Information Criterion; LCGA, latent class growth analysis; LLCA, longitudinal latent class analysis.

Journal Article.  5782 words.  Illustrated.

Subjects: Public Health and Epidemiology

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