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Chen CCG, Kao ML, Lulseged BA, Khatry SK, Singh M, LeClerq SC, Katz J, Tielsch JM, Mullany LC. Risk Factors of Pelvic Floor Disorders Among Women in Rural Nepal: A Case-Control Study. Int Urogynecol J 2024; 35:1643-1652. [PMID: 38958728 DOI: 10.1007/s00192-024-05843-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 06/02/2024] [Indexed: 07/04/2024]
Abstract
INTRODUCTION AND HYPOTHESIS Risk factors for pelvic floor disorders (PFDs) are not well understood in lower resource settings. The objective of this study is to determine the risk factors associated with stress urinary incontinence (SUI), urge urinary incontinence (UUI), and pelvic organ prolapse (POP) among women of reproductive age in rural Nepal. METHODS This is a case-control study nested within a community-based cross-sectional survey of parous women of reproductive age with PFDs in the Sarlahi District of Nepal. The presence of PFDs was confirmed by clinical assessment. Detailed sociodemographic information and histories were captured. RESULTS We examined 406 women; the mean (SD, range) age was 32.7 (8.5, 16-49) years, mean BMI (SD) was 19.7 (3.3) kg/m2, and median (range) number of pregnancies was 4 (1-11). Two hundred and three women (50.0%) had either SUI or UUI, 85 (17.8%) had both SUI and UUI, and 71 (17.5%) had POP at or beyond the hymen. After controlling for other variables significant on bivariate analysis, age (adjusted odds ratio [aOR] 1.06 [95% CI 1.03-1.09]), illiteracy (aOR 2.24 [95% CI 1.04-4.80]), and presence of upper gastrointestinal issues (aOR 3.30, [95% CI 1.77-6.16]) were independently associated with SUI/UUI. Age (aOR 1.05 [95% CI 1.02-1.09]), bispinous diameter (aOR 2.88 ([95% CI 1.11-7.47]), and subpubic angle (aOR 2.78 [95% CI 1.55-5.03]) were independently associated with POP. CONCLUSION Risk factors for PFDs in a homogenous community of parous women of reproductive age in rural Nepal are similar to those found in parous women in higher income countries.
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Affiliation(s)
- Chi Chiung Grace Chen
- Female Pelvic Medicine and Reconstructive Surgery, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, 21205, USA.
| | - Monica L Kao
- Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, Pittsburgh, PA, USA
| | | | | | - Meeta Singh
- Department of Obstetrics and Gynecology, Institute of Medicine, Kathmandu, Nepal
| | - Steven C LeClerq
- Nepal Nutrition Intervention Project-Sarlahi, Kathmandu, Nepal
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Joanne Katz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - James M Tielsch
- Milken Institute School of Public Health, Department of Global Health, George Washington University, Washington, DC, USA
| | - Luke C Mullany
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Jerez-Roig J, Farrés-Godayol P, Yildirim M, Escribà-Salvans A, Moreno-Martin P, Goutan-Roura E, Rierola-Fochs S, Romero-Mas M, Booth J, Skelton DA, Giné-Garriga M, Minobes-Molina E. Prevalence of urinary incontinence and associated factors in nursing homes: a multicentre cross-sectional study. BMC Geriatr 2024; 24:169. [PMID: 38368318 PMCID: PMC10874568 DOI: 10.1186/s12877-024-04748-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 01/25/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND Urinary incontinence (UI) is a common geriatric syndrome with high health and socio-economic impacts in nursing home (NH) residents. OBJECTIVES To estimate the prevalence and types of UI and its associated factors in older people living in NHs in Central Catalonia (Spain). We also determined the proportion of residents who were receiving behavioural strategies to prevent/manage UI. DESIGN AND SETTING Cross-sectional study in 5 NHs conducted from January to March 2020. METHODS We included consenting residents aged 65 + permanently living in the NHs. Residents who were hospitalized, in a coma or palliative care were excluded. UI was assessed using Section H of the Minimum Data Set. Sociodemographic and health-related variables were examined. Descriptive, bivariate, and multivariate (logistic regression) analyses were performed. RESULTS We included 132 subjects (82.6% women), mean age of 85.2 (SD = 7.4) years. The prevalence of UI was 76.5% (95% CI: 68.60-82.93). The most common type was functional UI (45.5%), followed by urgency UI (11.4%). Only 46.2% of residents received at least one behavioural strategy to manage UI. Most sedentary behaviour (SB) variables presented a p-value lower than 0.001 in the bivariate analyses, but none remained in the final model. Moderate-severe cognitive impairment (OR = 4.44, p =.003), anticholinergic activity (OR = 3.50, p =.004) and risk of sarcopenia using SARC-F (OR = 2.75, p =.041) were associated with UI. CONCLUSIONS The prevalence of UI was high in this sample of NH residents compared to the literature, yet less than half received prompted voiding as a strategy to prevent/reduce UI.UI was associated with cognitive impairment, anticholinergic activity, and risk of sarcopenia.
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Affiliation(s)
- Javier Jerez-Roig
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
| | - Pau Farrés-Godayol
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain.
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain.
| | - Meltem Yildirim
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
| | - Anna Escribà-Salvans
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
| | - Pau Moreno-Martin
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
| | - Ester Goutan-Roura
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
- Research group on Tissue Repair and Regeneration Laboratory (TR2Lab), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic- Central University of Catalonia (UVic-UCC), Barcelona, Spain
| | - Sandra Rierola-Fochs
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
| | - Montse Romero-Mas
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
| | - Joanne Booth
- Research Centre for Health (ReaCH), School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Dawn A Skelton
- Research Centre for Health (ReaCH), School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Maria Giné-Garriga
- Blanquerna Faculty of Psychology, Education and Sport Sciences, Ramon Llull University, Barcelona, Spain
- Blanquerna Faculty of Health Sciences, Ramon Llull University, Barcelona, Spain
| | - Eduard Minobes-Molina
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
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Lima ACP, Maximiano-Barreto MA, Martins TCR, Luchesi BM. Factors associated with poor health literacy in older adults: A systematic review. Geriatr Nurs 2024; 55:242-254. [PMID: 38070263 DOI: 10.1016/j.gerinurse.2023.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2023] [Revised: 11/24/2023] [Accepted: 11/27/2023] [Indexed: 02/06/2024]
Abstract
OBJECTIVES To identify factors associated with poor health literacy in older adults. METHODS A systematic literature review was conducted, employing the descriptors "Aged" and "Health Literacy". PROSPERO - CRD 42022350140. RESULTS Out of 23,500 articles screened, 176 were selected. Several factors associated with poor health literacy in older adults were identified, such as sociodemographic (e.g., advanced age, low educational level, non-white population, and others), social (e.g., poor family/social support, loneliness, social isolation, few social activities, and others), economic (e.g., lower income and/or lower socioeconomic status) and health aspects (e.g., poor health, chronic conditions, mental health challenges, hospitalizations, frailty, physical inactivity, cognitive impairment, and others). CONCLUSIONS The factors associated with poor health literacy in older adults identified in this review could contribute to future research, support interventions to improve health literacy, and assist professionals in planning educational activities and public policies.
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Affiliation(s)
- Ana Caroline Pinto Lima
- Campus de Três Lagoas, Programa de Pós-Graduação em Enfermagem, Federal University of Mato Grosso do Sul, Três Lagoas, MS, Brazil
| | | | - Tatiana Carvalho Reis Martins
- Campus de Três Lagoas, Programa de Pós-Graduação em Enfermagem, Federal University of Mato Grosso do Sul, Três Lagoas, MS, Brazil; Instituto Integrado de Saúde, Federal University of Mato Grosso do Sul, Campo Grande, MS, Brazil
| | - Bruna Moretti Luchesi
- Campus de Três Lagoas, Programa de Pós-Graduação em Enfermagem, Federal University of Mato Grosso do Sul, Três Lagoas, MS, Brazil; Research Group on Mental Health, Cognition and Aging, Federal University of São Carlos, São Carlos, SP, Brazil.
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Dijkman EM, ter Brake WWM, Drossaert CHC, Doggen CJM. Assessment Tools for Measuring Health Literacy and Digital Health Literacy in a Hospital Setting: A Scoping Review. Healthcare (Basel) 2023; 12:11. [PMID: 38200917 PMCID: PMC10778720 DOI: 10.3390/healthcare12010011] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2023] [Revised: 12/11/2023] [Accepted: 12/14/2023] [Indexed: 01/12/2024] Open
Abstract
Assessment of (digital) health literacy in the hospital can raise staff awareness and facilitate tailored communication, leading to improved health outcomes. Assessment tools should ideally address multiple domains of health literacy, fit to the complex hospital context and have a short administration time, to enable routine assessment. This review aims to create an overview of tools for measuring (digital) health literacy in hospitals. A search in Scopus, PubMed, WoS and CINAHL, following PRISMA guidelines, generated 7252 hits; 251 studies were included in which 44 assessment tools were used. Most tools (57%) were self-reported and 27% reported an administration time of <5 min. Almost all tools addressed the domain 'understanding' (98%), followed by 'access' (52%), 'apply' (50%), 'appraise' (32%), 'numeracy' (18%), and 'digital' (18%). Only four tools were frequently used: the Newest Vital Sign (NVS), the Short Test of Functional Health Literacy for Adults ((S)TOFHLA), the Brief Health Literacy Screener (BHLS), and the Health Literacy Questionnaire (HLQ). While the NVS and BHLS have a low administration time, they cover only two domains. HLQ covers the most domains: access, understanding, appraise, and apply. None of these four most frequently used tools measured digital skills. This review can guide health professionals in choosing an instrument that is feasible in their daily practice, and measures the required domains.
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Affiliation(s)
- Eline M. Dijkman
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands; (E.M.D.)
- Department of Surgery, Isala Hospital, 8025 AB Zwolle, The Netherlands
| | - Wouter W. M. ter Brake
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands; (E.M.D.)
| | | | - Carine J. M. Doggen
- Department of Health Technology and Services Research (HTSR), Technical Medical Centre, University of Twente, 7522 NB Enschede, The Netherlands; (E.M.D.)
- Clinical Research Center, Rijnstate Hospital, 6815 AD Arnhem, The Netherlands
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Egbujie BA, Northwood M, Turcotte LA, McArthur C, Berg K, Heckman GA, Wagg AS, Hirdes JP. Predictors of improvement in urinary incontinence in the postacute setting: A Canadian cohort study. Neurourol Urodyn 2022; 41:1749-1763. [PMID: 36040456 PMCID: PMC9805031 DOI: 10.1002/nau.25018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/16/2022] [Accepted: 07/21/2022] [Indexed: 01/09/2023]
Abstract
PURPOSE To determine factors associated with improvement in urinary incontinence (UI) for long-stay postacute, complex continuing care (CCC) patients. DESIGN A retrospective cohort investigation of patients in a CCC setting using data obtained from the Canadian Institute for Health Information's Continuing Care Reporting System collected with interRAI Minimum Data Set 2.0. SETTING AND PARTICIPANTS Individuals aged 18 years and older, were admitted to CCC hospitals in Ontario, Canada, between 2010 and 2018. METHODS Multivariable logistic regression was used to determine the independent effects of predictors on UI improvement, for patients who were somewhat or completely incontinent on admission and therefore had the potential for improvement. RESULTS The study cohort consisted of 18 584 patients, 74% (13 779) of which were somewhat or completely incontinent upon admission. Among those patients with potential for improvement, receiving bladder training, starting a new medication 90 days prior (odds ratio, OR: 1.54 [95% confidence interval, CI: 1.36-1.75]), and triggering the interRAI Urinary Incontinence Clinical Assessment Protocol to facilitate improvement (OR: 1.36 [95% CI: 1.08-1.71]) or to prevent decline (OR: 1.32 [95% CI: 1.13-1.53]) were the strongest predictors of improvement. Conversely, being totally dependent on others for transfer (OR: 0.62 [95% CI: 0.42-0.92]), is rarely or never understood (OR: 0.65 [95% CI: 0.50-0.85]), having a major comorbidity count of ≥3 (OR: 0.72 [95% CI: 0.59-0.88]), Parkinson's disease, OR: 0.77 (95% CI: 0.62-0.95), Alzheimer/other dementia, OR: 0.83 (95% CI: 0.74-0.93), and respiratory infections, OR: 0.57 (95% CI: 0.39-0.85) independently predicted less likelihood of improvement in UI. CONCLUSIONS AND IMPLICATIONS Findings of this study suggest that improving physical function, including bed mobility, and providing bladder retraining have strong positive impacts on improvement in UI for postacute care patients. Evidence generated from this study provides useful care planning information for care providers in identifying patients and targeting the care that may lead to better success with the management of UI.
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Affiliation(s)
| | | | - Luke A. Turcotte
- School of Public Health SciencesUniversity of WaterlooWaterlooOntarioCanada
| | - Caitlin McArthur
- School of PhysiotherapyDalhousie UniversityHalifaxNova ScotiaCanada
| | - Katherine Berg
- Department of Physical TherapyUniversity of TorontoTorontoOntarioCanada
| | - George A. Heckman
- School of Public Health SciencesUniversity of WaterlooWaterlooOntarioCanada,Schlegel Research Chair in Geriatric MedicineSchlegel‐University of Waterloo Research Institute for AgingWaterlooOntarioCanada
| | - Adrian S. Wagg
- Department of Medicine, Division of Geriatric MedicineUniversity of AlbertaEdmontonAlbertaCanada
| | - John P. Hirdes
- School of Public Health SciencesUniversity of WaterlooWaterlooOntarioCanada
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Northwood M, Turcotte LA, McArthur C, Egbujie BA, Berg K, Boscart VM, Heckman GA, Hirdes JP, Wagg AS. Changes in Urinary Continence After Admission to a Complex Care Setting: A Multistate Transition Model. J Am Med Dir Assoc 2022; 23:1683-1690.e2. [PMID: 35870485 DOI: 10.1016/j.jamda.2022.06.019] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2022] [Revised: 06/14/2022] [Accepted: 06/18/2022] [Indexed: 10/17/2022]
Abstract
OBJECTIVES To examine changes in urinary continence for post-acute, Complex Continuing Care hospital patients from time of admission to short-term follow-up, either in hospital or after discharge to long-term care or home with services. DESIGN Retrospective cohort study of patients in Complex Continuing Care hospitals using clinical data collected with interRAI Minimum Data Set 2.0 and interRAI Resident Assessment Instrument Home Care. SETTING AND PARTICIPANTS Adults aged 18 years and older, admitted to Complex Continuing Care hospitals in Ontario, Canada, between 2009 and 2015 (n = 78,913). METHODS A multistate transition model was used to characterize the association between patient characteristics measured at admission and changes in urinary continence state transitions (continent, sometimes continent, and incontinent) between admission and follow-up. RESULTS The cohort included 27,896 patients. At admission, 9583 (34.3%) patients belonged to the continent state, 6441 (23.09%) patients belonged to the sometimes incontinent state, and the remaining 11,872 (42.6%) patients belonged to the incontinent state. For patients who were continent at admission, the majority (62.7%) remained continent at follow-up. However, nearly a quarter (23.9%) transitioned to the sometimes continent state, and an additional 13.4% became incontinent at follow-up. Several factors were associated with continence state transitions, including cognitive impairment, rehabilitation potential, stroke, Parkinson's disease, Alzheimer's disease and related dementias, and hip fracture. CONCLUSIONS AND IMPLICATIONS This study suggests that urinary incontinence is a prevalent problem for Complex Continuing Care hospital patients and multiple factors are associated with continence state transitions. Standardized assessment of urinary incontinence is helpful in this setting to identify patients in need of further assessment and patient-centered intervention and as a quality improvement metric to examine changes in continence from admission to discharge.
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Affiliation(s)
| | - Luke A Turcotte
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Caitlin McArthur
- School of Physiotherapy, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | - Katherine Berg
- Department of Physical Therapy, University of Toronto, Toronto, Ontario, Canada
| | | | - George A Heckman
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada; Schlegel Research Chair in Geriatric Medicine, Schlegel-University of Waterloo Research Institute for Aging, Waterloo, Ontario, Canada
| | - John P Hirdes
- School of Public Health Sciences, University of Waterloo, Waterloo, Ontario, Canada
| | - Adrian S Wagg
- Department of Medicine, Division of Geriatric Medicine, University of Alberta, Edmonton, Alberta, Canada
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Van Besien W, Shire S, Decalf V, Ervin CE, King S, Baldrey C, Da Silva A, Wagg A, Everaert KE, Bower WF. The Bladder at Night during Hospitalisation: Towards optimal care for elderly patients with nocturia. Int J Clin Pract 2021; 75:e14876. [PMID: 34525254 DOI: 10.1111/ijcp.14876] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Revised: 07/20/2021] [Accepted: 09/12/2021] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVE This study aimed to describe the characteristics of nocturia in older hospitalised patients and to explore knowledge, beliefs and experiences associated with night toileting while in hospital in order to identify unmet care needs. METHODS A multisite mixed methods cross-sectional study of older hospitalised adults who were admitted for ≥2 days was conducted using a standardised researcher-administered questionnaire. An additional cohort 16 older hospitalised adults with nocturia >twice per night were interviewed to understand the experience and impact of nocturia during hospitalisation. RESULTS Nocturia was experienced by 260 out of 308 participants. In-hospital nocturia was significantly correlated with nocturia in the month preceding admission, high diurnal voiding frequency and nocturnal urinary urgency. Bother was attributed to multiple nocturia episodes. Participants had poor knowledge and understanding of nocturia and believed the symptom to be a normal occurrence; only 20% had discussed management with staff. Disrupted sleep and fear of falling were common in older immobile participants with nocturia. CONCLUSION Nocturia is highly prevalent in hospitalised older people. Toileting multiple times at night bothers patients, disrupts sleep, heightens a fear of falling yet is rarely addressed in ward management plans. A screening process to identify, assess, provide education and intervene for nocturia has the potential to improve wellbeing, safety at night and to address risk factors.
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Affiliation(s)
- Wouter Van Besien
- Faculty of Medicine and Health Sciences, Department of Public Health and Primary Care, Ghent University, Ghent, Belgium
| | - Samia Shire
- Faculty of Medicine and Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Veerle Decalf
- Faculty of Medicine and Health Sciences, Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Claire E Ervin
- Continence Service, Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
| | - Sharyn King
- Continence Service, Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
| | - Christine Baldrey
- Continence Service, Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
| | - Alisha Da Silva
- Department of Allied Health, Discipline of Physiotherapy, Royal Melbourne Hospital, Parkville, Australia
| | - Adrian Wagg
- Faculty of Medicine and Dentistry, Department of Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Karel E Everaert
- Faculty of Medicine and Health Sciences, Department of Human Structure and Repair, Ghent University, Ghent, Belgium
| | - Wendy F Bower
- Faculty of Medicine and Health Sciences, Department of Human Structure and Repair, Ghent University, Ghent, Belgium
- Continence Service, Sub-Acute Community Services, Royal Melbourne Hospital, Parkville, Australia
- Department of Allied Health, Discipline of Physiotherapy, Royal Melbourne Hospital, Parkville, Australia
- Department of Aged Care, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Parkville, Australia
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8
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von Siebenthal M, Besic M, Gheinani AH, Akshay A, Lizun-Platoni S, Kunz N, Burkhard FC, Monastyrskaya K. Urinary miRNA profiles discriminate between obstruction-induced bladder dysfunction and healthy controls. Sci Rep 2021; 11:10204. [PMID: 33986358 PMCID: PMC8119692 DOI: 10.1038/s41598-021-89535-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2020] [Accepted: 04/28/2021] [Indexed: 02/07/2023] Open
Abstract
Urgency, frequency and incomplete emptying are the troublesome symptoms often shared between benign prostatic obstruction-induced (BLUTD) and neurogenic (NLUTD) lower urinary tract dysfunction. Previously, using bladder biopsies, we suggested a panel of miRNA biomarkers for different functional phenotypes of the bladder. Urine is a good source of circulating miRNAs, but sex- and age-matched controls are important for urinary metabolite comparison. In two groups of healthy subjects (average age 32 and 57 years old, respectively) the total protein and RNA content was very similar between age groups, but the number of secreted extracellular vesicles (uEVs) and expression of several miRNAs were higher in the young healthy male volunteers. Timing of urine collection was not important for these parameters. We also evaluated the suitability of urinary miRNAs for non-invasive diagnosis of bladder outlet obstruction (BOO). A three urinary miRNA signature (miR-10a-5p, miR-301b-3p and miR-363-3p) could discriminate between controls and patients with LUTD (BLUTD and NLUTD). This panel of representative miRNAs can be further explored to develop a non-invasive diagnostic test for BOO. The age-related discrepancy in the urinary miRNA content observed in this study points to the importance of selecting appropriate, age-matched controls.
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Affiliation(s)
- Michelle von Siebenthal
- Urology Research Laboratory, Department for BioMedical Research DBMR, University of Bern, Bern, Switzerland
| | - Mustafa Besic
- Urology Research Laboratory, Department for BioMedical Research DBMR, University of Bern, Bern, Switzerland
| | - Ali Hashemi Gheinani
- Urological Diseases Research Center, Boston Children's Hospital, Harvard Medical School, Boston, USA.,Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Akshay Akshay
- Urology Research Laboratory, Department for BioMedical Research DBMR, University of Bern, Bern, Switzerland
| | | | - Nadine Kunz
- Department of Urology, Inselspital University Hospital, 3010, Bern, Switzerland
| | - Fiona C Burkhard
- Urology Research Laboratory, Department for BioMedical Research DBMR, University of Bern, Bern, Switzerland.,Department of Urology, Inselspital University Hospital, 3010, Bern, Switzerland
| | - Katia Monastyrskaya
- Urology Research Laboratory, Department for BioMedical Research DBMR, University of Bern, Bern, Switzerland. .,Department of Urology, Inselspital University Hospital, 3010, Bern, Switzerland.
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Batmani S, Jalali R, Mohammadi M, Bokaee S. Prevalence and factors related to urinary incontinence in older adults women worldwide: a comprehensive systematic review and meta-analysis of observational studies. BMC Geriatr 2021; 21:212. [PMID: 33781236 PMCID: PMC8008630 DOI: 10.1186/s12877-021-02135-8] [Citation(s) in RCA: 58] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 03/07/2021] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND Urinary incontinence is a common condition in the general population and, in particular, the older adults population, which reduces the quality of life of these people, so this study aims to systematically examine and meta-analyse the overall prevalence of urinary incontinence in older women around the world and the related and influential factors. METHODS This report is a comprehensive systematic review and meta-analysis of the findings of research on urinary incontinence in older adults people across the world through looking for MEDLINE, Cochrane Library Sciencedirect, Embase, Scopus, ProQuest and Persian databases, namely iranmedex, magiran, and SID from January 2000 to April 2020, the heterogeneity of the experiments was measured using the I2 index and the data processing was done in the Systematic Meta-Analysis programme. RESULTS In 29 studies and the sample size of 518,465 people in the age range of 55-106 years, urinary incontinence in older adults' women in the world based on a meta-analysis of 37.1% (95% CI: 29.6-45.4%) was obtained. The highest prevalence of urinary incontinence was reported in older adults' women in Asia with 45.1% (95% CI: 36.9-53.5%). Meta-regression also showed that with increasing the sample size and year of the study, the overall prevalence of urinary incontinence in the older adults women of the world decreased and increased, respectively, which were statistically significant differences (P < 0.05). According to studies, the most important factors influencing the incidence of urinary incontinence in older women are women's age (p < 0.001), obesity (p < 0.001), diabetes (p < 0.001), women's education (p < 0.001), delivery rank (p < 0.001), hypertension (p < 0.001), smoking (p < 0.001). They also have urinary tract infections (p < 0.001). CONCLUSION Given the high prevalence of urinary incontinence in older women around the world, health policy makers must consider control and diagnostic measures in older women and prioritize treatment and rehabilitation activities.
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Affiliation(s)
- Sedighe Batmani
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Rostam Jalali
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Mohammadi
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Shadi Bokaee
- Faculty of Health and Life Sciences, School of Life Sciences, Coventry University, Coventry, UK
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Adaptation, validity and reliability of geriatric self-efficacy index for urinary incontinence (GSE-UI) in geriatric incontinents. Int Urol Nephrol 2021; 53:825-834. [PMID: 33389511 DOI: 10.1007/s11255-020-02721-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/13/2020] [Indexed: 10/22/2022]
Abstract
PURPOSE The purpose of this study was to translate and culturally adapt the GSE-UI for use with a Turkish population and to determine its validity and reliability. METHODS 120 elderly with UI aged 60 and over years (mean 72.89 ± 9.59 years) participated in this study. An interview was held to determine the type, severity and frequency if any, incontinence. Then, the Mini-Mental State Examination, IIQ-7, UDI-6 and I-QOL questionnaires were administered to the participants. After translating the tool to Turkish, test and retest was performed with an interval of 7-14 days. RESULTS The internal consistency of the first test of the GSE-UI-Turkish was excellent, with a Cronbach α of 0.95. The test-retest reliability of the GSE-UI-Turkish was found to be excellent (ICC = 0.94, 95% CI 0.92-0.96). The correlation coefficient between the GSE-UI-Turkish and the UDI-6, IIQ-7, I-QOL were found to be good to excellent (r = 0.68, r = 0.67, r = 0.81, r = 0.45, respectively; p < 0.0001). CONCLUSION Results of our study GSE-UI of Turkish version, self-efficacy evaluation in geriatric incontinence was a valid and reliable survey that can be used in clinical practice.
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Geboers B, Uiters E, Reijneveld SA, Jansen CJM, Almansa J, Nooyens ACJ, Verschuren WMM, de Winter AF, Picavet HSJ. Health literacy among older adults is associated with their 10-years' cognitive functioning and decline - the Doetinchem Cohort Study. BMC Geriatr 2018; 18:77. [PMID: 29558890 PMCID: PMC5859753 DOI: 10.1186/s12877-018-0766-7] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Accepted: 03/12/2018] [Indexed: 11/11/2022] Open
Abstract
Background Many older adults have low levels of health literacy which affects their ability to participate optimally in healthcare. It is unclear how cognitive decline contributes to health literacy. To study this, longitudinal data are needed. The aim of this study was therefore to assess the associations of cognitive functioning and 10-years’ cognitive decline with health literacy in older adults. Methods Data from 988 participants (mean age = 65.3) of the Doetinchem Cohort Study were analyzed. Health literacy was measured by the Brief Health Literacy Screening. Memory, mental flexibility, information processing speed, and global cognitive functioning were assessed at the same time as health literacy and also 10 years earlier. Logistic regression analyses were performed, adjusted for age, gender, and educational level. Results Higher scores on tests in all cognitive domains were associated with a lower likelihood of having low health literacy after adjustment for confounders (all ORs < 0.70, p-values<.001). Similar associations were found for past cognitive functioning (all ORs < 0.75, p-values<.05). Before adjustment, stronger cognitive decline was associated with a greater likelihood of having low health literacy (all ORs > 1.37, p-values<.05). These associations lost significance after adjustment for educational level, except for the association of memory decline (OR = 1.40, p = .023, 95% CI: 1.05 to 1.88). Conclusion Older adults with poorer cognitive functioning and stronger cognitive decline are at risk for having low health literacy, which can affect their abilities to promote health and self-manage disease. Low health literacy and declining cognitive functioning might be a barrier for person-centered care, even in relatively young older adults.
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Affiliation(s)
- Bas Geboers
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, FA10, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands.
| | - Ellen Uiters
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - Sijmen A Reijneveld
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, FA10, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands
| | - Carel J M Jansen
- Department of Communication and Information Studies, Faculty of Arts, University of Groningen, Groningen, the Netherlands
| | - Josué Almansa
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, FA10, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands
| | - Astrid C J Nooyens
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
| | - W M Monique Verschuren
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands.,Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Andrea F de Winter
- Department of Health Sciences, University Medical Center Groningen, University of Groningen, Hanzeplein 1, FA10, P.O. Box 30.001, 9700 RB, Groningen, the Netherlands
| | - H Susan J Picavet
- Centre for Nutrition, Prevention and Health Services, National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands
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