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Kakehi S, Wakabayashi H, Isono E, Takemura R, Sato Y, Otsuka Y, Nagai T, Nishioka S, Momosaki R. Association between sarcopenia and urinary dysfunction in patients with dysphagia. Arch Gerontol Geriatr 2024; 127:105577. [PMID: 39032316 DOI: 10.1016/j.archger.2024.105577] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2024] [Revised: 06/29/2024] [Accepted: 07/13/2024] [Indexed: 07/23/2024]
Abstract
INTRODUCTION The objective was to determine the relationship between sarcopenia and urinary dysfunction in patients with dysphagia. MATERIAL AND METHODS A cross-sectional study was conducted on 460 Japanese Sarcopenic Dysphagia Database participants. Urinary dysfunction was defined as either urinary incontinence or urethral catheter use. Sarcopenia was diagnosed according to the Asian Working Group for Sarcopenia 2019 criteria. Univariate and multivariate analyses assessed the association between urinary dysfunction and sarcopenia, calf circumference (CC), handgrip strength (HGS), and Barthel Index (BI). Logistic regression analysis was performed for urinary dysfunction adjusted for age, sex, setting, and CCI in addition to BI and HGS or CC or sarcopenia (model 1) or FILS and BI (model 2). RESULTS The mean age was 80.8 ± 10.5 years and urinary dysfunction in 137 participants. Urinary dysfunction was not associated with sarcopenia (123 versus 281, p = 0.440) but was associated with CC (27.4 ± 4.2 versus 28.5 ± 3.9, p = 0.009), HGS (9.7 ± 7.9 versus 14.4 ± 9.3, p < 0.001), and BI (19.9 ± 0.3 versus 20.3 ± 0.2, p < 0.001). Logistic regression analysis showed urinary dysfunction was associated with HGS (OR: 0.968, CI: 0.938, 0.998) and BI (OR: 0.955, CI: 0.943, 0.966). The cutoff was 19 kg for men (sensitivity 0.786, specificity 0.56, Area Under Curve (AUC) 0.689) and 6.1 kg for women (sensitivity 0.493, specificity 0.774, AUC 0.639) in HGS and 27.5 points in BI (sensitivity 0.781, specificity 0.604, AUC 0.740). CONCLUSION Sarcopenia was not associated with urinary dysfunction. However, HGS and BI were related to urinary dysfunction.
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Affiliation(s)
- Shingo Kakehi
- Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Hidetaka Wakabayashi
- Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan.
| | - Eri Isono
- Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Ryohei Takemura
- Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Yuka Sato
- Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Yukiko Otsuka
- Department of Nursing, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Takako Nagai
- Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, Tokyo, Japan
| | - Shinta Nishioka
- Department of Clinical Nutrition and Food Services, Nagasaki Rehabilitation Hospital, Nagasaki, Japan
| | - Ryo Momosaki
- Department of Rehabilitation Medicine, Mie University Graduate School of Medicine, Mie, Japan
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Obinata D, Hara M, Hashimoto S, Nakahara K, Yoshizawa T, Mochida J, Yamaguchi K, Takahashi S. Association Between Frailty and Pelvic Organ Prolapse in Elderly Women: A Retrospective Study. Int Urogynecol J 2024; 35:1889-1898. [PMID: 39186089 PMCID: PMC11420369 DOI: 10.1007/s00192-024-05898-x] [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: 05/28/2024] [Accepted: 07/22/2024] [Indexed: 08/27/2024]
Abstract
INTRODUCTION AND HYPOTHESIS This study evaluated the association between pelvic organ prolapse (POP), frailty, and sarcopenia to explore how POP treatment can extend healthy life expectancy in elderly women. METHODS We conducted a retrospective study of prospectively collected data, comparing women with mild POP (stages 0-II) with those with advanced POP (stages III and IV). The inclusion criteria for this study were women who visited the clinic with at least one symptom of pelvic floor dysfunction and underwent imaging studies between April 2020 and November 2022. Initially, 119 patients met these inclusion criteria. Patients were excluded if they had a history of previous POP treatment, did not respond to the study survey, or were lost to follow-up. After applying these exclusion criteria, 82 patients were included in the final analysis, of whom 65 underwent surgery (laparoscopic sacrocolpopexy, colpocleisis, tension-free vaginal tape, and native tissue repair). Assessments included POP Quantification, Kihon Checklist, Pelvic Organ Prolapse Quality of Life (P-QOL) questionnaire, International Prostate Symptom Score (IPSS), Overactive Bladder Symptom Score (OABSS), and Incontinence Symptom Questionnaire (ICIQ-SF). Pelvic muscles were measured using MRI or CT. Immunohistochemical analysis of estrogen receptor alpha (ERα), estrogen receptor beta , and androgen receptor was performed on surgical specimens from 43 patients. RESULTS The median age of participants was 75 years. Of the 82 patients, 48 (58.5%) were classified as frail or pre-frail, and 22 (26.8%) exhibited motor impairment. Advanced POP (stages 3 and 4) was seen in 41 patients. These patients had more motor function impairments (advanced, 16; mild, 6; p = 0.01). Patients with advanced POP had poorer P-QOL, ICIQ-SF (median: 9.5 vs 4, p = 0.006) and OABSS (7 vs 4, p = 0.008) scores, and smaller pubococcygeus muscle diameter (2.5 vs 3 cm, p = 0.017). Postoperatively, significant improvements were seen in P-QOL (all domains except personal relationships: p < 0.001), total IPSS (11 vs 4, p < 0.001), OABSS (6 vs 5, p = 0.033), and ICIQ-SF scores (6 vs 2, p < 0.001). ERα expression was associated with preoperative frailty (r = -0.37, p = 0.014). CONCLUSIONS Advanced POP correlates with poorer QOL, worse urinary symptoms, and reduced pubococcygeus muscle diameter, consistent with sarcopenia, compared with mild POP.
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Affiliation(s)
- Daisuke Obinata
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan.
| | - Makoto Hara
- Division of Neurology, Department of Medicine, Nihon University School of Medicine, Tokyo, Japan
| | - Sho Hashimoto
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan
| | - Ken Nakahara
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan
| | - Tsuyoshi Yoshizawa
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan
| | - Junichi Mochida
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan
| | - Kenya Yamaguchi
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan
| | - Satoru Takahashi
- Department of Urology, Nihon University School of Medicine, Tokyo, Japan
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Grosman Y, Kalichman L. Bidirectional Relationships between Sarcopenia and Pelvic Floor Disorders. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2024; 21:879. [PMID: 39063456 PMCID: PMC11276977 DOI: 10.3390/ijerph21070879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/01/2024] [Revised: 07/03/2024] [Accepted: 07/03/2024] [Indexed: 07/28/2024]
Abstract
Sarcopenia and pelvic floor disorders (PFDs) are prevalent and often cooccurring conditions in the aging population. However, their bidirectional relationship and underlying mechanisms remain underexplored. This narrative review aims to elucidate this relationship by exploring potential causative interplays, shared pathophysiological mechanisms, and common risk factors. A comprehensive literature search was conducted to identify relevant studies focusing on epidemiological associations, interaction mechanisms, and implications for patient care. While epidemiological studies demonstrate associations between sarcopenia and PFDs, our findings reveal a cyclical relationship where sarcopenia may exacerbate PFDs through mechanisms such as decreased muscle strength and mobility. Conversely, the presence of PFDs often leads to reduced physical activity due to discomfort and mobility issues, which in turn exacerbate the muscle atrophy associated with sarcopenia. Additionally, shared risk factors such as physical inactivity, nutritional deficiencies, metabolic syndrome, and menopausal hormonal changes likely contribute to the onset and progression of both conditions. These interactions underscore the importance of concurrently integrated care approaches that address both conditions. Effective management requires comprehensive screening, the recognition of contributing factors, and tailored exercise regimens supported by a multidisciplinary approach. Future research should focus on longitudinal studies tracking disease progression and evaluating the efficacy of multidisciplinary care models in optimizing patient outcomes.
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Affiliation(s)
- Yacov Grosman
- Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer Sheva 84105, Israel
- Department of Physical Therapy, Meuhedet Health Maintenance Organization, Hadera 3824242, Israel
| | - Leonid Kalichman
- Department of Physical Therapy, Recanati School for Community Health Professions, Faculty of Health Sciences, Ben-Gurion University of the Negev, P.O. Box 653, Beer Sheva 84105, Israel
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Fukata S, Kawaguchi A, Yoshimura R, Fukuhara H, Karashima T, Inoue K. Investigation of risk factors for vaginal dehiscence and development of small bowel evisceration after robot-assisted radical cystectomy for female bladder cancer and an improved vaginal reconstruction technique to prevent its onset. J Robot Surg 2024; 18:276. [PMID: 38954281 DOI: 10.1007/s11701-024-02035-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2024] [Accepted: 06/26/2024] [Indexed: 07/04/2024]
Abstract
Transvaginal organ prolapse, such as small bowel evisceration, is a rare complication after radical cystectomy (RC) in female patients with invasive bladder cancer, However, it often requires emergency surgical repair. Here, we describe our experience with such a case and a review of similar previously reported cases, along with evaluation of the risk factors. We also propose a vaginal reconstruction technique to prevent this complication during robot-assisted laparoscopic radical cystectomy (RARC). A total of 178 patients who underwent laparoscopic radical cystectomy (LRC) or RARC were enrolled, 34 of whom (19%) were female. One of the 34 female patients had transvaginal small bowel evisceration after RARC. We evaluated our case and six such previously reported cases, to determine vaginal reconstruction techniques during RARC to prevent this complication postoperatively. Median age of these cases was 73 (51-80) years, and all patients were postmenopausal. The median time to small bowel evisceration was 14 (6-120) weeks postoperatively. In addition, we changed the methods of the vaginal reconstruction technique during RARC from the conventional side-to-side closure technique to the improved caudal-to-cephalad closure technique. Since implementing this change, we have not experienced any cases of vaginal vault dehiscence or organ prolapse. Transvaginal small bowel evisceration after RC can easily become severe. Therefore, all possible preventive measures should be taken during RARC. We believe that our vaginal reconstruction techniques might reduce the risk of developing this complication.
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Affiliation(s)
- Satoshi Fukata
- Department of Urology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan.
| | - Ayano Kawaguchi
- Department of Urology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan
| | - Rie Yoshimura
- Department of Urology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan
| | - Hideo Fukuhara
- Department of Urology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan
| | - Takashi Karashima
- Department of Urology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan
| | - Keiji Inoue
- Department of Urology, Kochi Medical School, Kochi University, Kohasu, Oko-cho, Nankoku, Kochi, 783-8505, Japan
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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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Fukai S, Maeda S, Chikazawa K, Rikiyama T. Strangulated bowel obstruction caused by vaginal perforation due to vaginal cancer in a patient with chronic uterine prolapse. BMJ Case Rep 2023; 16:e255815. [PMID: 38086574 PMCID: PMC10728924 DOI: 10.1136/bcr-2023-255815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2023] [Indexed: 12/18/2023] Open
Abstract
A woman in her 90s with chronic uterine prolapse presented with abdominal pain and a vaginal mass. The patient had generalised peritonitis and a strangulated bowel obstruction originating from a perforated posterior vagina. We performed partial intestinal resection and a total hysterectomy, including excision of the perforation of the vaginal site and the adnexa. The patient died on postoperative day 8 due to worsening systemic sepsis. The pathological diagnosis revealed an invasive carcinoma in the perforated area of the vagina. Obstetric factors are the most frequent cause of female genital tract perforation, and chronic uterine prolapse is associated with this condition; however, vaginal cancer has never been reported as a cause of perforation. Therefore, close collaboration in gynaecology should be considered to investigate whether vaginal perforation and uterine prolapse are related to cancer.
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Affiliation(s)
- Shota Fukai
- Department of Urology, Jichi Medical University Saitama Medical Center, Saitama, Japan
| | - Shimpei Maeda
- Jichi Ika University Saitama Medical Center, Saitama, Japan
| | - Kenro Chikazawa
- Obstetrics and Gynecology, Jichi Medical University, Saitama Medical Center, Saitama-shi, Japan
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Sahiner Z, Mangır N, Güner M, Ceylan S, Hafizoglu M, Karaduman D, Atbas C, Bas AO, Özer YP, Balcı C, Dogu BB, Halil M, Cankurtaran M. The relationship between urinary incontinence and abdominal muscle thickness in community-dwelling older women undergoing comprehensive geriatric assessment. Eur Geriatr Med 2023; 14:1319-1325. [PMID: 37837573 DOI: 10.1007/s41999-023-00874-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2023] [Accepted: 09/27/2023] [Indexed: 10/16/2023]
Abstract
PURPOSE Urinary incontinence (UI) is one of the most common geriatric syndromes in older adults, especially in women. The aim of this study is to show the relationship between urinary incontinence and abdominal muscle thickness measured by muscle ultrasonography (US) in community-dwelling older women adults. METHODS Eighty-seven community-dwelling older women participated in our study. The presence and the type of UI were recorded. Clinical and demographic characteristics were collected, and a comprehensive geriatric assessment was performed on all participants. Abdominal muscle layer thicknesses were evaluated with muscle US. RESULTS The prevalence of UI was 55.2% (n = 48) of the study population. The median [IQR] age of the patients in the UI group was 73.0 [69.0-77.5] years and it was 69.0 [67.0-73.0] years in patients without UI (p = 0.007). Abdominal muscle thicknesses were measured smaller in patients with UI than those without UI except for internal oblique muscle thickness. The median [IQR] rectus abdominis muscle thickness was lower in patients with UI than in patients without UI, and the difference was statistically significant (p < 0.003). RA muscle was associated with UI regardless of age, polypharmacy, malnutrition, and frailty (OR: 0.58; 95% CI 0.38-0.89; p = 0.01). CONCLUSIONS We have shown that UI was independently related to the rectus abdominis muscle thickness, which may reflect the function and mass of the pelvic floor muscles.
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Affiliation(s)
- Zeynep Sahiner
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey.
| | - Naside Mangır
- Department of Urology, Faculty of Medicine, Hacettepe University, Ankara, Turkey
| | - Merve Güner
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
| | - Serdar Ceylan
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
| | - Merve Hafizoglu
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
| | - Didem Karaduman
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
| | - Cansu Atbas
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
| | - Arzu Okyar Bas
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
| | - Yasemin Polat Özer
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
| | - Cafer Balcı
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
| | - Burcu Balam Dogu
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
| | - Meltem Halil
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
| | - Mustafa Cankurtaran
- Faculty of Medicine, Department of Internal Medicine, Division of Geriatrics, Hacettepe University, 06230, Altındağ, Ankara, Turkey
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GANİDAĞLI S, ÖZTÜRK E, ÖZTÜRK ZA. Recurrent lower urinary tract infections: more than an infection for older women. Turk J Med Sci 2023; 53:1395-1403. [PMID: 38813006 PMCID: PMC10763801 DOI: 10.55730/1300-0144.5706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 10/26/2023] [Accepted: 05/09/2023] [Indexed: 05/31/2024] Open
Abstract
Background/aim Older adults tend to have more urinary tract infections (UTIs). The frequency of recurrent lower urinary tract infections (rLUTIs) increases with age. rLUTIs are associated with long-term chronic effects on geriatric syndromes in older adults. We aimed to investigate possible risk factors that influence rLUTIs in older adults based on comprehensive geriatric assessment (CGA). Materials and methods This cross-sectional study included 235 older adults admitted to Gaziantep University's Geriatric Outpatient Clinic between June 1 and November 30, 2022. All patients underwent CGA. The Geriatric Depression Scale (GDS), the European Quality of Life-Five Dimension (EQ-5D) questionnaire, the Pittsburgh Sleep Quality Index (PSQI), the Katz Index of Activities of Daily Living (ADL), the Lawton and Brody Index of Instrumental Activities of Daily Living (IADL), and the Mini Nutritional Assessment (MNA) tool were,administered. Handgrip strength (HGS) and gait speed were also measured, and the number of falls in the last year was recorded. Results The mean age of the participants was 72.8 ± 6.8 years and 61.3% were female. Sixty-four patients had rLUTIs. The rLUTI group had higher frequencies of sarcopenia, hypertension, and diabetes; higher numbers of comorbidities and medications; higher GDS and PSQI scores; and more reported falls. They had lower ADL, MNA, EQ-5D, and gait speed scores. HGS was found to be lower in women with rLUTIs. Higher numbers of comorbidities and GDS scores and lower HGS were independent predictors of rLUTIs in women (p = 0.011, OR: 1.75; p = 0.018, OR: 1.14; and p = 0.042, OR: 0.91, respectively). Conclusion We revealed that decreased HGS, higher GDS, and the number of comorbidities in older women were independent risk factors for rLUTIs. Our findings offer a new perspective on the importance of CGA in diagnosing and preventing rLUTIs.
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Affiliation(s)
- Sencer GANİDAĞLI
- Department of Internal Medicine, Division of Geriatric Medicine, Faculty of Medicine, Gaziantep University, Gaziantep, Türkiye
Turkiye
| | - Ercüment ÖZTÜRK
- Department of Internal Medicine, Division of Geriatric Medicine, Faculty of Medicine, Gaziantep University, Gaziantep, Türkiye
Turkiye
| | - Zeynel Abidin ÖZTÜRK
- Department of Internal Medicine, Division of Geriatric Medicine, Faculty of Medicine, Gaziantep University, Gaziantep, Türkiye
Turkiye
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Li L, Chen F, Li X, Gao Y, Zhu S, Diao X, Wang N, Xu T. Association between calf circumference and incontinence in Chinese elderly. BMC Public Health 2023; 23:471. [PMID: 36899309 PMCID: PMC10007784 DOI: 10.1186/s12889-023-15324-4] [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: 11/08/2022] [Accepted: 02/27/2023] [Indexed: 03/12/2023] Open
Abstract
BACKGROUND The objective of this study was to analyze the association between calf circumference and incontinence in Chinese elderly, and to find out the maximal cut-off point by gender for the use of calf circumference in screening for incontinence. METHODS In this study, participants were from the 2018 Chinese Longitudinal Healthy Longevity Survey (CLHLS). The maximal calf circumference cut-off point and other incontinence-related risk factors were explored using receiver operating characteristic (ROC) curves and logistic regression analysis. RESULTS The study included 14,989 elderly people (6,516 males and 8,473 females) over 60. The prevalence of incontinence in elderly males was 5.23% (341/6,516), significantly lower than females, which was 8.31% (704/8,473) (p < 0.001). There was no correlation between calf circumference < 34 cm in males and < 33 cm in females and incontinence after adjusting the confounders. We further stratified by gender to predict incontinence in elderly based on the Youden index of ROC curves. We found the association between calf circumference and incontinence was the strongest when the cut-off points were < 28.5 cm for males and < 26.5 cm for females, with an odds rate (OR) value of 1.620 (male, 95%CI: 1.197-2.288) and 1.292 (female, 95%CI: 1.044-1.600) after adjusting the covariates, respectively. CONCLUSIONS Our study suggests that calf circumference < 28.5 cm in males and < 26.5 cm in females is a risk factor for incontinence in the Chinese elderly population. Calf circumference should be measured in routine physical examination, and timely interventions should be made to reduce the risk of incontinence in subjects with calf circumference less than the threshold.
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Affiliation(s)
- Lin Li
- Clinical Medical Center, National Research Institute for Family Planning, Beijing, China
| | - Feilong Chen
- Department of Epidemiology and Biostatistics Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China
| | - Xiaoyan Li
- Center for Health Quality, National Research Institute for Family Planning, Beijing, China
| | - Yiyuan Gao
- Center for Health Quality, National Research Institute for Family Planning, Beijing, China
| | - Silin Zhu
- Department of Statistics, Central China Normal University, Hubei, China
| | - Xiyezi Diao
- Department of Statistics, Central China Normal University, Hubei, China
| | - Ning Wang
- Center for Health Quality, National Research Institute for Family Planning, Beijing, China.
| | - Tao Xu
- Department of Epidemiology and Biostatistics Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences & School of Basic Medicine, Peking Union Medical College, Beijing, China.
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10
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Fang J, Ye J, Huang Q, Lin Y, Weng Y, Wang M, Chen Y, Lu Y, Zhang R. Risk factors of pelvic floor muscle strength in south Chinese women: a retrospective study. BMC Pregnancy Childbirth 2022; 22:624. [PMID: 35933360 PMCID: PMC9356495 DOI: 10.1186/s12884-022-04952-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2022] [Accepted: 07/26/2022] [Indexed: 12/31/2022] Open
Abstract
Objectives To evaluate pelvic floor muscle strength using surface electromyography and risk factors for pelvic floor muscle strength in the early postpartum period. Methods This retrospective study included 21,302 participants who visited Fujian
Maternity and Child Health Hospital from September 2019 to February 2022. All participants
were assessed by
medical professionals for general information and surface electromyography. Results Univariate analysis indicated that age was inversely related to tonic and endurance contractions. In contrast, all the other variables, including education level, body mass index, neonatal weight, and number of fetuses, had a positive impact on rapid, tonic, and endurance contractions. Likewise, parity was also positively associated with rapid contractions. In addition, compared with vaginal delivery, cesarean section delivery had a protective effect on the amplitude of the three types of contractions. Stepwise regression analysis showed that both age and neonatal weight had a negative linear relationship with the amplitude of rapid, tonic and endurance contractions. In contrast, the amplitude of rapid, tonic and endurance contractions significantly increased as body mass index, parity (≤ 3), education level and gestational weight gain (endurance contractions only) increased. Participants with cesarean section delivery showed positive effects on rapid, tonic, and endurance contractions compared to participants with vaginal delivery. Conclusions We found that age, neonatal weight, vaginal delivery, episiotomy, and forceps delivery were risk factors for pelvic floor muscle strength; in contrast, body mass index, parity (≤ 3) and gestational weight gain had a positive relationship with pelvic floor muscle strength.
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Affiliation(s)
- Jianqi Fang
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, 350000, People's Republic of China.,Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People's Republic of China
| | - Jiajia Ye
- Department of Rehabilitation Assessment, Rehabilitation Hospital, Fujian University of Traditional Chinese Medicine, Fujian, 350000, Fuzhou, People's Republic of China
| | - Qing Huang
- College of Environment and Public Health, Xiamen Huaxia University, Xiamen Fujian, People's Republic of China
| | - Yang Lin
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, 350000, People's Republic of China.,Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People's Republic of China
| | - Yilin Weng
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, 350000, People's Republic of China.,Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People's Republic of China
| | - Miao Wang
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, 350000, People's Republic of China.,Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People's Republic of China
| | - Yi Chen
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, 350000, People's Republic of China.,Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People's Republic of China
| | - Yao Lu
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, 350000, People's Republic of China.,Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People's Republic of China
| | - Ronghua Zhang
- Department of Women's Health Care, Fujian Maternity and Child Health Hospital, Fuzhou, Fujian, 350000, People's Republic of China. .,Department of Rehabilitation Assessment, Rehabilitation Hospital Affiliated to Fujian University of Traditional Chinese Medicine, Fuzhou, Fujian, 350000, People's Republic of China.
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11
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Neshatian L, Lam JP, Gurland BH, Liang T, Becker L, Sheth VR. MRI biomarker of muscle composition is associated with severity of pelvic organ prolapse. Tech Coloproctol 2022; 26:725-733. [PMID: 35727428 DOI: 10.1007/s10151-022-02651-8] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 05/29/2022] [Indexed: 12/01/2022]
Abstract
BACKGROUND The pathophysiology of pelvic organ prolapse is largely unknown. We hypothesized that reduced muscle mass on magnetic resonance defecography (MRD) is associated with increased pelvic floor laxity. The aim of this study was to compare the psoas and puborectalis muscle mass composition and cross-sectional area among patients with or without pelvic laxity. METHODS An observational retrospective study was conducted on women > age 18 years old who had undergone MRD for pelvic floor complaints from January 2020 to December 2020 at Stanford Pelvic Health Center. Pelvic floor laxity, pelvic organ descent, and rectal prolapse were characterized by standard measurements on MRD and compared to the psoas (L4 level) and puborectalis muscle index (cross-sectional area adjusted by height) and relative fat fraction, quantified by utilizing a 2-point Dixon technique. Regression analysis was used to quantify the association between muscle characteristics and pelvic organ measurements. RESULTS The psoas fat fraction was significantly elevated in patients with abnormally increased resting and strain H and M lines (p < 0.05) and increased with rising grades of Oxford rectal prolapse (p = 0.0001), uterovaginal descent (p = 0.001) and bladder descent (p = 0.0005). In multivariate regression analysis, adjusted for age and body mass index, the psoas fat fraction (not muscle index) was an independent risk factor for abnormal strain H and M line; odds ratio (95% confidence interval) of 17.8 (2-155.4) and 18.5 (1.3-258.3) respectively, and rising Oxford grade of rectal prolapse 153.9 (4.4-5383) and bladder descent 12.4 (1.5-106). Puborectalis fat fraction was increased by rising grades of Oxford rectal prolapse (p = 0.0002). CONCLUSIONS Severity of pelvic organ prolapse appears to be associated with increasing psoas muscle fat fraction, a biomarker for reduced skeletal muscle mass. Future prospective research is needed to determine if sarcopenia may predict postsurgical outcomes after pelvic organ prolapse repair.
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Affiliation(s)
- L Neshatian
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, CA, Stanford, USA.
| | - J P Lam
- American Radiology Associates, Dallas, TX, USA
| | - B H Gurland
- Department of Surgery, Stanford University School of Medicine, Stanford, CA, USA
| | - T Liang
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
| | - L Becker
- Division of Gastroenterology and Hepatology, Stanford University School of Medicine, CA, Stanford, USA
| | - V R Sheth
- Department of Radiology, Stanford University School of Medicine, Stanford, CA, USA
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12
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Escribà-Salvans A, Jerez-Roig J, Molas-Tuneu M, Farrés-Godayol P, Moreno-Martin P, Goutan-Roura E, Güell-Masramon H, Amblàs-Novellas J, de Souza DLB, Skelton DA, Torres-Moreno M, Minobes-Molina E. Sarcopenia and associated factors according to the EWGSOP2 criteria in older people living in nursing homes: a cross-sectional study. BMC Geriatr 2022; 22:350. [PMID: 35448983 PMCID: PMC9022416 DOI: 10.1186/s12877-022-02827-9] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2021] [Accepted: 02/01/2022] [Indexed: 01/11/2023] Open
Abstract
Background In 2018, the European Working Group on Sarcopenia in Older People (EWGSOP2) updated the original definition of sarcopenia, establishing new criteria to be used globally. Early diagnosis of sarcopenia in nursing home residents and the identification of contributing factors would target interventions to reduce the incidence of malnutrition, social isolation, functional decline, hospitalization and mortality. Aim Verify the prevalence and the degree of severity of sarcopenia according to the new EWSGOP2 criteria and to analyse its associated factors in residents living in nursing homes in Central Catalonia (Spain). Design A cross-sectional multicenter study was conducted in 4 nursing homes. SARC-F test was applied as the initial screening, muscle strength was measured by a dynamometer, skeletal muscle mass by bioimpedance analysis and physical performance by Gait Speed. Four categories were used: total probable sarcopenia, probable sarcopenia, confirmed sarcopenia and severe sarcopenia. Results Among the total sample of 104 nursing home residents (mean age 84.6, ± 7.8; median 86, IQR 110), 84.6% were women and 85 (81.7%) (95% confidence interval [CI] 73.0-88.0) had total probable sarcopenia, 63 (60.5%) had probable sarcopenia, 19 (18.3%) had confirmed sarcopenia and 7 (6.7%) had severe sarcopenia. In the bivariate analysis, obesity was negatively associated and total time in sedentary behavior positively associated with all sarcopenia categories. In addition, malnutrition and urinary continence were positively associated with total and probable sarcopenia. Urinary incontinence was a positive associated factor of total and probable sarcopenia. In the multivariate analysis, obesity represented a negative associated factor: OR = 0.13 (0.03 - 0.57), p = 0.007 and OR = 0.14 (0.03 - 0.60), p = 0.008 with total and probable sarcopenia, respectively, adjusted by urinary incontinence status. For confirmed sarcopenia, obesity also represented a negative associated factor OR = 0.06 (0.01 - 0.99), p = 0.049 and the total time in sedentary behavior a positive associated factor OR = 1.10 (1.00- 1.20), p = 0.040. Conclusions According the EWGSOP2 criteria, high prevalence of sarcopenia was found in institutionalized older people, ranging from 6.7 to 81.7% depending on the category. Malnutrition, urinary incontinence and total time in sedentary behavior were associated with sarcopenia, whilst obesity represented a protective factor in this population.
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Affiliation(s)
- 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, 08500, Barcelona, VIC, Spain
| | - 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, 08500, Barcelona, VIC, Spain.
| | - Miriam Molas-Tuneu
- 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, 08500, 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, 08500, 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, 08500, Barcelona, VIC, Spain
| | - Ester Goutan-Roura
- 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), C. Sagrada Família, 7, 08500, Barcelona, VIC, Spain
| | - Helena Güell-Masramon
- 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, 08500, Barcelona, VIC, Spain
| | - Jordi Amblàs-Novellas
- Central Catalonia Chronicity Research Group (C3RG), Centre for Health and Social Care Research (CESS), Faculty of Medicine, University of Vic-Central University of Catalonia (UVIC-UCC), C. Sagrada Família, 7, VIC, 08500, Barcelona, Spain
| | - Dyego Leandro Bezerra de Souza
- 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, 08500, Barcelona, VIC, Spain.,Department of Collective Health, Federal University of Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil
| | - Dawn A Skelton
- Research Centre for Health (ReaCH), School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Miriam Torres-Moreno
- 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, 08500, Barcelona, VIC, 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, 08500, Barcelona, VIC, Spain
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13
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Mizuno S, Wakabayashi H, Yamakawa M, Wada F, Kato R, Furiya Y, Nishioka S, Momosaki R. Sarcopenia Is Associated with Fecal Incontinence in Patients with Dysphagia: Implication for Anal Sarcopenia. J Nutr Health Aging 2022; 26:84-88. [PMID: 35067708 DOI: 10.1007/s12603-021-1711-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVES To examine the relationship between sarcopenia and fecal incontinence in patients with dysphagia. DESIGN Cross-sectional study using the Japanese sarcopenic dysphagia database. SETTING 19 hospitals including 9 acute care hospitals, 8 rehabilitation hospitals, 2 long-term care hospitals, and 1 home visit rehabilitation center. PARTICIPANTS 460 dysphagic patients, aged 20 years and older. MEASUREMENTS Sarcopenia was diagnosed by the 2019 criteria of the Asian Working Group for Sarcopenia. Fecal incontinence was assessed by health care professionals at baseline according to the definition of the Japanese Practice Guidelines for Fecal Incontinence. We examined whether there was a significant difference between the rate of fecal incontinence in patients with/without sarcopenia. Age, sex, type of dwelling, Barthel index, Charlson comorbidity index (CCI), calf circumference, handgrip strength, body mass index, malnourishment, C-reactive protein level, serum albumin level, and delivery of enteral nutrition by nasogastric and/or gastrostomy tube were measured. To examine the relationship between sarcopenia and fecal incontinence, logistic regression analysis was performed with adjustments for age, sex, sarcopenia, CCI, enteral nutrition, and dwelling. RESULTS The mean age of patients was 81 ± 10 years. Of the 460 study patients, 404 (88%) patients had sarcopenia and 104 had fecal incontinence (23%). The rate of fecal incontinence was higher in the sarcopenia group than the non-sarcopenia group (25% vs. 7%, P = 0.003). Logistic regression analysis showed that sarcopenia was independently associated with fecal incontinence (odds ratio: 3.114, 95% confidence interval: 1.045, 9.282). CONCLUSION The prevalence of fecal incontinence was 23% in patients with dysphagia. Sarcopenia was independently associated with fecal incontinence, which suggests the presence of anal sarcopenia. Defecation control should be assessed in patients with sarcopenia.
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Affiliation(s)
- S Mizuno
- Hidetaka Wakabayashi, MD, PhD, Department of Rehabilitation Medicine, Tokyo Women's Medical University Hospital, 8-1, Kawada-cho, Shinjuku-ku, Tokyo, Japan. Code; 162-0054, Tel: +81-3-3353-8111, Fax: +81-3-5269-7639, E-mail:
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