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Li X, Zhou W, Hu G. The association between non-alcoholic fatty liver disease and urinary incontinence among adult females in the United States. BMC Public Health 2024; 24:1373. [PMID: 38778285 PMCID: PMC11110403 DOI: 10.1186/s12889-024-18578-8] [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: 06/21/2023] [Accepted: 04/11/2024] [Indexed: 05/25/2024] Open
Abstract
BACKGROUND AND OBJECTIVES Non-alcoholic fatty liver disease (NAFLD) and urinary incontinence (UI) are both highly prevalent and age-related diseases. Nevertheless, the link between NAFLD and UI is unclear. Hence, the study was designed to evaluate the association between the NAFLD and UI (including UI types) in a nationally representative sample of United States (US) female adults. METHODS We conducted this study used data from U.S. female adults in the National Health and Nutrition Examination Survey (NHANES) 2017-March 2020 (pre-pandemic) cycles. The diagnosis of NAFLD is based on Vibration controlled transient elastography (VCTE) and absence of know liver diseases and significant alcohol consumption. The diagnosis and types of UI were assessment using a self-report questionnaire. Multivariable logistic regression models were used to analyze the association between NALFD and UI. Stratified analyses based on age, obesity, race, educational level, married status, PIR, and smoking status were conducted. RESULTS Of the 2149 participants, the mean (95% CI) age was 53.9 (52.7-55.0), 686 (61.1%) were Non-Hispanic White. UI was significantly more common in participants with NAFLD [490 (64.7%)] than those without NAFLD [552 (44.9%)]. Adjusted for age, race/ethnicity, marital status, educational level, family poverty income ratio (PIR) status, alanine aminotransferase (ALT), aspartate aminotransferase (AST), smoking status, obesity, type 2 diabetes mellitus (T2DM), hypertension and insulin resistance (IR) in a multivariable logistic regression model, NALFD were associated with UI [OR: 1.93, 95%CI 1.23-3.02, P = 0.01] and urge UI [OR: 1.55, 95%CI 1.03-2.33, P = 0.03], while patients with NAFLD did not show an increased odds in stress UI and mixed UI when compared with those without NAFLD subject (P > 0.05). In the subgroup analyses, NAFLD remained significantly associated with UI, particularly among those participants without obesity (OR: 2.69, 95% CI 1.84-4.00) and aged ≥ 60 years (OR: 2.20, 95% CI 1.38-3.51). CONCLUSIONS Among US female adults, NAFLD has a strong positive correlation with UI. Given that NAFLD is a modifiable disease, these results may help clinicians to target female patients with NAFLD for treatments and interventions that may help prevent the occurrence of UI and reduce the symptoms of UI.
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Affiliation(s)
- Xinyuan Li
- Department of Gastroenterology, The First Affiliated Hospital of University of South China, Hengyang, Hunan, 421001, People's Republic of China
| | - Weiwei Zhou
- Department of Gastroenterology, The First Affiliated Hospital of University of South China, Hengyang, Hunan, 421001, People's Republic of China.
| | - Guangsheng Hu
- Department of Gastroenterology, The First Affiliated Hospital of University of South China, Hengyang, Hunan, 421001, People's Republic of China.
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Kravitz E, Thompson JJ, Christiansen T, Arya L, Andy U, Kim EK. Dual Incontinence and Risk of Fall: A Retrospective Cohort Study. UROGYNECOLOGY (PHILADELPHIA, PA.) 2024; 30:280-285. [PMID: 38484243 DOI: 10.1097/spv.0000000000001467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/19/2024]
Abstract
IMPORTANCE Although there is a known association between urinary incontinence (UI) and fall risk, it is unclear if having both UI and fecal incontinence, or dual incontinence (DI), increases this risk. OBJECTIVE The objective of our study was to elucidate a relationship between DI and falls. STUDY DESIGN This was a retrospective cohort study at a tertiary academic health system of female patients 65 years and older presenting for a new patient visit to a urogynecology health care professional for UI from 2019 to 2021. Demographic data and responses to intake questionnaires on fall and markers of frailty were extracted. Multivariable logistic regression was performed to identify factors associated with fall adjusting for covariates identified upon univariate comparison. RESULTS A total of 2,814 women were included in the analysis; 2,661 patients reported UI alone, and 153 reported DI. A greater proportion of women with DI reported a fall in the past year compared with those with UI alone (22.9% vs 12.2%, P < 0.001). Univariable comparison showed that these 2 groups differed regarding age, body mass index, and estimated median household income. On multivariable logistic regression, DI was significantly associated with falls (adjusted odds ratio 2.56; 95% confidence interval, 1.02-5.46). Other factors independently associated with falls in older women with UI include (adjusted odds ratio, 95% confidence interval): lower income groups (2.35, 1.50-3.67 for $20,000-$40,000, compared with $100,000 and higher-income group), difficulty with activities of daily living (1.60, 1.25-2.13), and unintentional weight loss (1.68, 1.05-2.68). CONCLUSION Patients with DI have a 2-fold higher risk of fall compared with patients with UI alone.
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Affiliation(s)
- Elizabeth Kravitz
- From the Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Jacqueline J Thompson
- From the Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA
| | | | - Lily Arya
- From the Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA
| | - Uduak Andy
- From the Department of Obstetrics and Gynecology, Hospital of the University of Pennsylvania, Philadelphia, PA
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3
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Reaves S, Arya LA, Newman DK, Wyman J, Klusaritz H, Walsh W, Brown RT, Andy UU. Reducing Falls in Older Women with Urinary Incontinence. ADVANCES IN GERIATRIC MEDICINE AND RESEARCH 2024; 5:e230011. [PMID: 38454916 PMCID: PMC10919213 DOI: 10.20900/agmr20230011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/09/2024]
Abstract
Urinary incontinence is common in older women and doubles the risk of falls in this population. The association between urinary incontinence, especially urgency urinary incontinence, and falls is multifactorial and likely the result of a complex interaction between physical, mental, social, and environmental factors. As a result of this multifactorial etiology and based on existing evidence, the integration of different fall prevention strategies including strength and resistance exercises, bladder training, and home hazard reduction have the potential to decrease the risk of falls in older women with urinary incontinence. Given the prevalence of urinary incontinence and the significant morbidity associated with falls, effective interventions to reduce fall risk in older women with urinary incontinence is of high public health significance.
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Affiliation(s)
- Simone Reaves
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA
| | - Lily A. Arya
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA
| | - Diane K. Newman
- Department of Surgery, University of Pennsylvania, Philadelphia, PA, USA
| | - Jean Wyman
- School of Nursing, University of Minnesota, Minneapolis, MN, USA
| | - Heather Klusaritz
- Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USA
| | - Wendy Walsh
- Department of Occupational Therapy, Saint Joseph’s University, Philadelphia, PA, USA
| | - Rebecca T. Brown
- Division of Geriatric Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Uduak U. Andy
- Department of Obstetrics and Gynecology, University of Pennsylvania, Philadelphia, PA, USA
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4
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Fisher SR, Villasante-Tezanos A, Allen LM, Pappadis MR, Kilic G. Comparative effectiveness of pelvic floor muscle training, mirabegron, and trospium among older women with urgency urinary incontinence and high fall risk: a feasibility randomized clinical study. Pilot Feasibility Stud 2024; 10:1. [PMID: 38178267 PMCID: PMC10765875 DOI: 10.1186/s40814-023-01440-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 12/21/2023] [Indexed: 01/06/2024] Open
Abstract
BACKGROUND Untreated, urgency urinary incontinence (UUI) and overactive bladder (OAB) can precipitate a vicious cycle of decreasing physical activity, social isolation, fear of falling, and falls. Structured behavioral interventions and medications are common initial treatment options, but they elicit their effects through very different mechanisms of action that may influence fall-related outcomes differently. This study will determine the feasibility of conducting a comparative effectiveness, three-arm, mixed methods, randomized clinical trial of a behaviorally based pelvic floor muscle training (PFMT) intervention versus two recent drug options in older women with UUI or OAB who are also at increased risk of falling. METHODS Forty-eight women 60 years and older with UUI or OAB who screen positive for increased fall risk will be recruited through the urogynacology and pelvic health clinics of our university health system. Participants will be randomly assigned to one of three 12-week treatment arms: (1) a course of behavioral and pelvic floor muscle training (PFMT) provided by physical therapists; (2) the beta-3 agonist, mirabegron; and (3) the antimuscarinic, trospium chloride. Study feasibility will be established through objective metrics of evaluability, adherence to the interventions, and attrition. We will also assess relevant measures of OAB symptom severity, quality of life, physical activity, incident falls, and concern about falling. DISCUSSION The proposed research seeks to ultimately determine if linkages between reduction in UI symptoms through treatment also reduce the risk of falling in this patient population. TRIAL REGISTRATION NCT05880862. Registered on 30 May 2023.
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Affiliation(s)
- Steve R Fisher
- Department of Physical Therapy, University of Texas Medical Branch at Galveston, Galveston, USA.
| | | | - Lindsay M Allen
- Department of Physical Therapy, University of Texas Medical Branch at Galveston, Galveston, USA
| | - Monique R Pappadis
- Department of Population Health and Health Disparities, University of Texas Medical Branch at Galveston, Galveston, USA
| | - Gokhan Kilic
- Department of Obstetrics and Gynecology, University of Texas Medical Branch at Galveston, Galveston, USA
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5
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Badrkhahan SZ, Ala M, Fakhrzadeh H, Yaghoobi A, Mirzamohamadi S, Arzaghi SM, Shahabi S, Sharifi F, Ostovar A, Fahimfar N, Nabipour I, Larijani B, Shafiee G, Heshmat R. The prevalence and predictors of geriatric giants in community-dwelling older adults: a cross-sectional study from the Middle East. Sci Rep 2023; 13:12401. [PMID: 37524849 PMCID: PMC10390524 DOI: 10.1038/s41598-023-39614-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Accepted: 07/27/2023] [Indexed: 08/02/2023] Open
Abstract
The term "geriatric giants" refers to the chronic disabilities of senescence leading to adverse health outcomes. This study aimed to investigate the prevalence and predictors of geriatric giants in Southern Iran. The participants were selected from Bushehr city using a multistage cluster random sampling method. Demographic data were collected through interviews. Frailty, incontinence, immobility, depression, cognitive impairment, and malnutrition were measured by questionnaires and instruments. Finally, data from 2392 participants were analyzed. The prevalence of fecal incontinence was less than 1% among all participants and similar in men and women. In contrast, compared with men, women had higher prevalence of urinary incontinence (36.44% vs. 17.65%), depression (39.05% vs. 12.89%), anorexia and malnutrition (2.35% vs. 0.82%), immobility (8.00% vs. 2.5%), frailty (16.84 vs. 7.34), and pre-frailty (54.19 vs. 38.63%). The prevalence of dependence and cognitive impairment was also higher in women and considerably increased with the age of participants. In total, 12.07% of subjects were frail, and 46.76% were pre-frail. The prevalence of frailty exponentially increased in older age, ranging from 4.18% among those aged 60-64 years to 57.35% in those aged ≥ 80 years. Considering 95% confidence interval (CI), multivariate logistic regression revealed that low physical activity [odds ratio (OR) 31.73 (18.44-54.60)], cancer (OR 3.28 (1.27-8.44)), depression [OR 2.42 (1.97-2.98)], age [OR 1.11 (1.08-1.14)], waist circumference [OR 1.03 (1.01-1.06)], BMI [OR 1.07 (1.01-1.14)], MNA score [OR 0.85 (0.79-0.92)], polypharmacy [OR 2.26 (1.30-3.95)] and male gender [OR 0.63 (0.42-0.93)] were independently associated with frailty. White blood cell count (WBC), smoking, marital status, and number of comorbidities were not independently associated with frailty. Low physical activity was the strongest predictor of frailty, which may need more attention in geriatric care. Frailty, its predictors, and other components of geriatric giants were considerably more common among women and older ages.
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Affiliation(s)
- Seyedeh Zahra Badrkhahan
- Department of Geriatric Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Cardiac Primary Prevention Research Center, Cardiovascular Disease Research Institute, Tehran Heart Center (THC), Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Moein Ala
- Experimental Medicine Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Hossein Fakhrzadeh
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Arash Yaghoobi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Sara Mirzamohamadi
- Experimental Medicine Research Center, Tehran University of Medical Sciences (TUMS), Tehran, Iran
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Seyed Masoud Arzaghi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Sina Shahabi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
- School of Medicine, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Farshad Sharifi
- Elderly Health Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
| | - Afshin Ostovar
- Non-Commutable Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences (TUMS), Tehran, Iran.
| | - Noushin Fahimfar
- Osteoporosis Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Iraj Nabipour
- The Persian Gulf Marine, Biotechnology Research Center, The Persian Biomedical Sciences Research Institute, Bushehr University of Medical Sciences, Bushehr, Iran
| | - Bagher Larijani
- Endocrinology and Metabolism Research Center, Endocrinology and Metabolism Clinical Sciences Institute, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Gita Shafiee
- Chronic Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences (TUMS), Tehran, Iran
| | - Ramin Heshmat
- Chronic Disease Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences (TUMS), Tehran, Iran
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6
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Wu S, Wu F. Association of urinary incontinence with depression among men: a cross-sectional study. BMC Public Health 2023; 23:944. [PMID: 37231365 DOI: 10.1186/s12889-023-15961-9] [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: 11/27/2022] [Accepted: 05/23/2023] [Indexed: 05/27/2023] Open
Abstract
OBJECTIVE Depression and urinary incontinence (UI) are both troubling symptoms that severely impact quality of life. The aim of this study is to evaluate the association between UI (including UI types and severity) and depression among men. POPULATION AND METHODS The analyzed data was collected from the 2005-2018 National Health and Nutrition Examination Survey (NHANES) data. A total of 16,694 male participants aged ≥ 20 years with complete information about depression and UI were included in this study. Logistic regression was performed to calculate the odds ratio (OR) and 95% confidence interval (CI) to determine the association between depression and UI by adjusting for relevant covariables. RESULTS The prevalence of depression was 10.91% among participants with UI. Urge UI was the main type of UI and accounts for 50.53% of all UI types. The adjusted ORs for the association between depression and UI were 2.69 (95%CI, 2.20-3.28). Compared with slight UI, the adjusted ORs were 2.28 (95% CI, 1.61-3.23) for moderate UI, 2.98 (95% CI, 1.54-5.74) for severe UI, and 3.85 (95% CI, 1.83-8.12) for very severe UI. Compared with no UI, the adjusted ORs were 4.46 (95% CI, 3.16-6.29) for mixed UI, 3.15 (95% CI, 2.06-4.82) for stress UI, and 2.43 (95% CI, 1.89-3.12) for urge UI. The subgroup analyses also showed similar correlation about depression and UI. CONCLUSION Among men, depression was positively associated with UI status, severity and types. For clinicians, it's necessary to screen depression in patients with UI.
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Affiliation(s)
- Shasha Wu
- Department of Gastroenterology, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, Sichuan, People's Republic of China
| | - Feixiang Wu
- Department of Urology, The Third Hospital of Mianyang, Sichuan Mental Health Center, Mianyang, Sichuan, People's Republic of China.
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7
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Soysal P, Veronese N, Ippoliti S, Pizzol D, Carrie AM, Stefanescu S, López-Sánchez GF, Barnett Y, Butler L, Koyanagi A, Jacob L, Ghaydya RA, Sheyn D, Hijaz AK, Oliva-Lozano JM, Muyor JM, Trott M, Kronbichler A, Grabovac I, Tully MA, Yang L, Hwang J, Kim JY, Park S, Song J, Shin JI, Ilie PC, Smith L. The impact of urinary incontinence on multiple health outcomes: an umbrella review of meta-analysis of observational studies. Aging Clin Exp Res 2023; 35:479-495. [PMID: 36637774 DOI: 10.1007/s40520-022-02336-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 12/21/2022] [Indexed: 01/14/2023]
Abstract
BACKGROUND AND AIM We aimed to capture the breadth of health outcomes that have been associated with the presence of Urinary Incontinence (UI) and systematically assess the quality, strength, and credibility of these associations through an umbrella review and integrated meta-analyses. METHODS We assessed meta-analyses of observational studies based on random-effect summary effect sizes and their p-values, 95% prediction intervals, heterogeneity, small-study effects, and excess significance. We graded the evidence from convincing (Class I) to weak (Class IV). RESULTS AND DISCUSSION From 3172 articles returned in search of the literature, 9 systematic reviews were included with a total of 41 outcomes. Overall, 37 out of the 41 outcomes reported nominally significant summary results (p < 0.05), with 22 associations surviving the application of a more stringent p-value (p < 10-6). UI was associated with worse scores than controls in female sexual function (Class II), while it was also associated with a higher prevalence of depression (odds ratio [OR] = 1.815; 95% confidence interval [CI]: 1.551-2.124), and anxiety (OR = 1.498; 95% CI: 1.273-1.762) (Class IV). UI was associated with poorer quality of life (QoL), higher rate of mortality (hazard ratio = 2.392; 95% CI: 2.053-2.787) an increase in falls, frailty, pressure ulcers, diabetes, arthritis, and fecal incontinence (Class IV). CONCLUSIONS UI is associated with female sexual dysfunction, with highly suggestive evidence. However, the evidence of other adverse outcomes including depression, anxiety, poorer QoL, higher mortality, falls, pressure ulcers, diabetes, arthritis, fecal incontinence, and frailty is only weak. A multidimensional approach should be taken in managing UI in the clinical setting.
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Affiliation(s)
- Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Adnan Menderes Bulvarı (Vatan Street), Fatih, 34093, Istanbul, Turkey
| | - Nicola Veronese
- Department of Internal Medicine, Geriatrics Section, University of Palermo, Palermo, Italy
| | - Simona Ippoliti
- Urology Department, Hull University Teaching Hospitals NHS Trust, Hull, UK
| | - Damiano Pizzol
- Italian Agency for Development Cooperation, 33 Street, Amarat, 79371, Khartoum, Sudan
| | | | | | - Guillermo F López-Sánchez
- Division of Preventive Medicine and Public Health, Department of Public Health Sciences, School of Medicine, University of Murcia, Murcia, Spain
| | - Yvonne Barnett
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Laurie Butler
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, 08830, Barcelona, Spain.,ICREA, Pg. Lluis Companys 23, 08010, Barcelona, Spain
| | - Louis Jacob
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, ISCIII, 08830, Barcelona, Spain.,Faculty of Medicine, University of Versailles Saint-Quentin-en-Yvelines, 78180, Montigny-le-Bretonneux, France
| | - Ramy Abou Ghaydya
- Department of Urology, University Hospitals Cleveland Medical Center, 11000 Euclid Avenue, Cleveland, OH, USA.,Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - David Sheyn
- Department of Urology, University Hospitals Cleveland Medical Center, 11000 Euclid Avenue, Cleveland, OH, USA.,Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Adonis K Hijaz
- Department of Urology, University Hospitals Cleveland Medical Center, 11000 Euclid Avenue, Cleveland, OH, USA.,Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Jose M Muyor
- Health Research Centre, University of Almeria, Almeria, Spain
| | - Mike Trott
- Centre for Public Health, Queen's University Belfast, Belfast, UK
| | - Andreas Kronbichler
- Department of Internal Medicine IV, Medical University Innsbruck, Innsbruck, Austria
| | - Igor Grabovac
- Department of Social and Preventive Medicine, Centre for Public Health, Medical University of Vienna, 1090, Vienna, Austria
| | - Mark A Tully
- School of Medicine, Ulster University, Londonderry, BT48 7JL, UK
| | - Lin Yang
- Department of Cancer Epidemiology and Prevention Research, Cancer Control Alberta, Alberta Health Services, Calgary, Canada.,Departments of Oncology and Community Health Sciences, University of Calgary, Calgary, Canada
| | - Jimin Hwang
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Jong Yeob Kim
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Seoyeon Park
- Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Junmin Song
- Keimyung University School of Medicine, Daegu, Republic of Korea
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, 03722, Republic of Korea.
| | - Petre-Cristian Ilie
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
| | - Lee Smith
- Centre for Health Performance and Wellbeing, Anglia Ruskin University, Cambridge, UK
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Efficacy and Safety of Vibegron for the Treatment of Overactive Bladder in Women: A Subgroup Analysis From the Double-Blind, Randomized, Controlled EMPOWUR Trial. UROGYNECOLOGY (HAGERSTOWN, MD.) 2023; 29:48-57. [PMID: 36384907 DOI: 10.1097/spv.0000000000001258] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
IMPORTANCE The international phase 3 EMPOWUR trial demonstrated efficacy and safety of vibegron, a newer β 3 -adrenergic receptor agonist, in adults with overactive bladder (OAB). Women are disproportionately affected by OAB, especially those with bothersome symptoms, such as urge urinary incontinence (UUI). OBJECTIVE This subgroup analysis from EMPOWUR assessed efficacy and safety of vibegron in women. STUDY DESIGN In EMPOWUR, patients with OAB were randomized 5:5:4 to 12 weeks of treatment with once-daily vibegron 75 mg, placebo, or tolterodine 4-mg extended release. Efficacy end points included change from baseline at week 12 in mean daily number of micturitions, UUI episodes, and urgency episodes. Safety was assessed through adverse events (AEs). RESULTS Of the patients included in the analysis, 1286 (84.9%) were women (vibegron, n = 463; placebo, n = 459; tolterodine, n = 364). At week 12, women receiving vibegron showed significant reductions (95% confidence intervals of least squares mean differences does not include 0) from baseline versus placebo in mean daily micturitions, UUI episodes, and urgency episodes, with least squares mean differences (95% confidence intervals) of -0.5 (-0.8 to -0.2), -0.7 (-1.0 to -0.4), and -0.8 (-1.3 to -0.4), respectively. Treatment-emergent AE incidence was similar with vibegron (39%) and placebo (35%); the most common AE with incidence higher with vibegron (4.3%) than placebo (2.6%) was headache. CONCLUSIONS In this subgroup analysis, women receiving vibegron showed significant reductions in key efficacy end points versus placebo and favorable safety profile, consistent with the overall results from EMPOWUR, suggesting that vibegron is efficacious and safe for the treatment of OAB in this patient population.
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9
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Zhang Y. The effect of incontinence on depression among older adults: a longitudinal study in China. Public Health 2022; 212:58-65. [DOI: 10.1016/j.puhe.2022.08.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Revised: 07/09/2022] [Accepted: 08/30/2022] [Indexed: 11/11/2022]
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10
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Challenges and New Insights in the Management of Urinary Incontinence in Older Women. CURRENT GERIATRICS REPORTS 2022. [DOI: 10.1007/s13670-022-00375-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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11
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Sayabalian A. Putting an end to the blame game with incontinence. Geriatr Nurs 2022; 44:275-276. [DOI: 10.1016/j.gerinurse.2022.02.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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12
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Meyer C, Chapman A, Klattenhoff Reyes K, Joe A. Profiling the risk factors associated with falls in older people with diabetes receiving at-home nursing care: Retrospective analysis of an Australian aged care provider database. HEALTH & SOCIAL CARE IN THE COMMUNITY 2022; 30:762-775. [PMID: 33084170 DOI: 10.1111/hsc.13194] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 08/18/2020] [Accepted: 09/16/2020] [Indexed: 06/11/2023]
Abstract
Falls among older people with diabetes mellitus (DM) are a major health concern. Preventive measures can be implemented to reduce the likelihood of falls. The aim of this study was to determine the factors most strongly associated with falls in older people living with DM who receive at-home care support services. This will inform home-visiting nurses to prioritise falls prevention strategies in the care of clients who are at high risk of falls. A retrospective analysis of routinely collected data from a large not-for-profit community aged care service provider was undertaken. The sample comprised adults aged ≥65 years residing in Victoria, Australia, with a recorded diagnosis of DM, and who received at least one episode of care by the aged care provider during July 1, 2014 and June 30, 2015. Self-reported data on falls in previous 6 months was obtained via the Comprehensive Health Assessment Tool (CHAT). Selection of factors associated with falls was guided by the Falls Risk for Older People in the Community (FROP-Com) assessment tool. For the study population, data for these factors were obtained from clients' self-reported CHAT data, and from International Classification of Disease codes obtained from medical records. Descriptive statistics were used to identify the demographic and clinical profile; logistic regression was used to assess the strength of association between various factors and the occurrence of a fall. Data were obtained for 1,574 older adults; overall prevalence of falls was 30.6% (n = 482). Significant factors displaying the highest odds of falling were gait issues (OR: 2.11, p = 0.002); needing help to walk (OR: 1.91, p = <0.001); and cognitive dysfunction (OR: 1.55, p = 0.001). Interpreted with caution, several factors contribute to an increased odds of falling in older people with DM. Home-visiting nurses are uniquely placed to introduce preventive interventions to reduce the likelihood of debilitating falls in this population.
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Affiliation(s)
- Claudia Meyer
- Bolton Clarke Research Institute, Bentleigh, VIC, Australia
- Centre for Health Communication and Participation, La Trobe University, Bundoora, VIC, Australia
- Rehabilitation, Ageing and Independent Living Research Centre, Monash University, Frankston, VIC, Australia
| | - Anna Chapman
- Faculty of Health, Centre for Quality & Patient Safety, Institute for Health Transformation, School of Nursing & Midwifery, Deakin University, Geelong, VIC, Australia
- Monash Health, Clayton, VIC, Australia
| | | | - Angela Joe
- Bolton Clarke Research Institute, Bentleigh, VIC, Australia
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Short-Term Effect of Fesoterodine on Physical Function Relevant to Fall Risk in Older Women With Overactive Bladder. Female Pelvic Med Reconstr Surg 2021; 27:759-765. [PMID: 34807883 DOI: 10.1097/spv.0000000000001046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE The aim of this study was to measure the effect of treatment with fesoterodine on physical function relevant to fall risk in older women with overactive bladder. MATERIALS AND METHODS This was a prospective cohort study of women aged 65 years or older with overactive bladder. Urinary symptoms and physical function were measured at baseline and 8 weeks after treatment with fesoterodine. Physical activity and sedentary behavior were measured subjectively using questionnaires and objectively using an accelerometer. Physical function was measured using the Short Physical Performance Battery test. RESULTS We enrolled 75 women with a median age of 76 years. At baseline, bothersome urgency urinary incontinence and nocturia were reported by 55% and 81%, respectively. At baseline, participants were highly sedentary with a median of 2,118 steps daily. After treatment, urinary symptom severity and health-related quality of life subscale scores of the Overactive Bladder Questionnaire improved significantly (-22.3±24 and 17.5±19.7, respectively; P < 0.0001). The proportion of participants who self-reported a moderate-to-high level of physical activity increased from 27% to 35% after treatment (P = 0.86). However, daily steps decreased significantly (-420.2±949, P < 0.001), whereas daily sedentary time increased by 36.6±88 minutes (P < 0.001). There was no significant change in the Short Physical Performance Battery score (-0.3±2.3, P = 0.6). CONCLUSIONS In older women with overactive bladder, short-term treatment with fesoterodine decreased objectively measured physical activity with no significant change in physical function. Treatment with anticholinergics may need to be supplemented with other therapies to address fall risk in older women with overactive bladder.
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Prevalence and Predictors of Increased Fall Risk Among Women Presenting to an Outpatient Urogynecology and Pelvic Health Center. Female Pelvic Med Reconstr Surg 2021; 28:e7-e10. [PMID: 34628446 DOI: 10.1097/spv.0000000000001118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
OBJECTIVES The objective of this study was to determine the prevalence of increased fall risk among women presenting to a large pelvic health center using a screening method compatible with the busy clinic environment and to identify factors associated with increased risk. METHODS A retrospective medical records review was conducted on consecutive treatment-seeking women presenting to a Urogynecology & Pelvic Health Center over 6 months. The Centers for Disease Control and Prevention, Stopping Elderly Accidents, Deaths, and Injuries fall risk screening tool was included among the intake questionnaires all patients completed before their scheduled appointments. Relevant sociodemographic and clinical measures were abstracted from the electronic medical record. RESULTS Three hundred and forty-eight women completed the fall screen. One hundred and twenty-four (36%) screened positive for increased fall risk. Mean age was 58.7 ± 15.8 years. An age threshold of 68 years best discriminated between those who were and were not identified as at risk. There was a gradient of association between number of urinary symptoms and prevalence of increased fall risk. Patients with 3 or more urinary symptoms were most likely to screen positive (1: odds ratio [OR], 1.51 [0.86-2.66]; 2: OR, 1.62 [0.99-2.64]; 3 or more: OR, 1.84 [1.07-3.17]) after adjusting for other know fall risk factors. CONCLUSIONS The prevalence of increased fall risk in this patient population is high and highest in women with multiple urinary symptoms. The Stopping Elderly Accidents, Deaths, and Injuries screening tool was a feasible and nonintrusive screening method for identifying increased fall risk during routine patient care. Fall risk and concern about falling should be taken into consideration when deciding management strategies for urinary problems.
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15
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Kin Kok M, Vlaskovsky P, Low E, Shim R, Lian A. Within-unit bed moves in a short-stay in-patient unit are associated with increased falls. AUST HEALTH REV 2021; 45:497-503. [PMID: 33757625 DOI: 10.1071/ah20196] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 12/15/2020] [Indexed: 11/23/2022]
Abstract
Objective This study evaluated a patient's likelihood of a fall using information available at the time of presentation to a short-stay acute medical unit (AMU) with a high patient turnover rate and estimated the effect of within-unit bed moves on the occurrence of in-patient falls. Methods This study was a 3-year retrospective cross-sectional study of 28713 consecutive admissions comparing patients who fell and patients who did not fall. Factors assessed included premorbid falls risk factors, presenting issues and within-unit bed moves. Logistic regression was used to identify factors associated with patients who fell. Each admission was treated as a unit of measure. Results Of 28713 admissions, 182 (0.6%) involved at least one fall event. The fall rate was 5.67 falls per 1000 occupied bed days. Premorbid cognitive impairment (odds ratio (OR) 4.88), a presenting issue of confusion (OR 2.92) and a fall immediately before admission (OR 2.49) were associated with patients who fell (all P<0.001). Each bed move corresponded to a 27% increase in the odds of a fall (OR 1.27; P=0.027). Conclusion Premorbid cognitive impairment was the strongest risk factor for an in-patient fall on the unit. Within-unit bed moves significantly increased the risk of an in-patient fall and should be minimised. What is known about the topic? In-patient falls can cause significant patient harm at cost to the health system. There is limited research examining the association between within-unit bed moves and falls in a short-stay AMU. What does this paper add? Care in the short-stay AMU is complex and the number of bed moves is a modifiable factor that can reduce a patient's risk of an in-patient fall. What are the implications for practitioners? Bed moves need to be minimised, especially for patients with cognitive impairment. If bed moves are inevitable, operational plans can be designed to mitigate the increased risk caused by these moves.
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Affiliation(s)
- Mui Kin Kok
- Department of Internal Medicine, Royal Perth Hospital, Wellington Street, Perth, WA 6000, Australia. Emails: ; ; ; and Corresponding author.
| | - Philip Vlaskovsky
- The University of Western Australia, Mounts Bay Road, Crawley, WA 6009, Australia.
| | - Evelyn Low
- Department of Internal Medicine, Royal Perth Hospital, Wellington Street, Perth, WA 6000, Australia. Emails: ; ;
| | - Rae Shim
- Department of Internal Medicine, Royal Perth Hospital, Wellington Street, Perth, WA 6000, Australia. Emails: ; ;
| | - Alwin Lian
- Department of Internal Medicine, Royal Perth Hospital, Wellington Street, Perth, WA 6000, Australia. Emails: ; ;
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16
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Moon S, Chung HS, Kim YJ, Kim SJ, Kwon O, Lee YG, Yu JM, Cho ST. The impact of urinary incontinence on falls: A systematic review and meta-analysis. PLoS One 2021; 16:e0251711. [PMID: 34010311 PMCID: PMC8133449 DOI: 10.1371/journal.pone.0251711] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Accepted: 04/30/2021] [Indexed: 11/19/2022] Open
Abstract
OBJECTIVE Previous studies on the association between urinary incontinence (UI) and falls have reported conflicting results. We, therefore, aimed to evaluate and clarify this association through a systematic review and meta-analysis of relevant studies. METHODS We performed a literature search for relevant studies in databases including PubMed and EMBASE from inception up to December 13, 2020, using several search terms related to UI and falls. Based on the data reported in these studies, we calculated the pooled odds ratios (ORs) for falls and the corresponding 95% confidence intervals (CIs) using the Mantel-Haenszel method. RESULTS This meta-analysis included 38 articles and a total of 230,129 participants. UI was significantly associated with falls (OR, 1.62; 95% CI, 1.45-1.83). Subgroup analyses based on the age and sex of the participants revealed a significant association between UI and falls in older (≥65 years) participants (OR, 1.59; 95% CI, 1.31-1.93), and in both men (OR, 1.88; 95% CI, 1.57-2.25) and women (OR, 1.41; 95% CI, 1.29-1.54). Subgroup analysis based on the definition of falls revealed a significant association between UI and falls (≥1 fall event) (OR, 1.61; 95% CI, 1.42-1.82) and recurrent falls (≥2 fall events) (OR, 1.63; 95% CI, 1.49-1.78). According to the UI type, a significant association between UI and falls was observed in patients with urgency UI (OR, 1.76; 95% CI, 1.15-1.70) and those with stress UI (OR, 1.73; 95% CI, 1.39-2.15). CONCLUSIONS This meta-analysis, which was based on evidence from a review of the published literature, clearly demonstrated that UI is an important risk factor for falls in both general and older populations.
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Affiliation(s)
- Shinje Moon
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Hye Soo Chung
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Yoon Jung Kim
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Sung Jin Kim
- Department of Urology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Ohseong Kwon
- Department of Urology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Young Goo Lee
- Department of Urology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Jae Myung Yu
- Division of Endocrinology and Metabolism, Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
| | - Sung Tae Cho
- Department of Urology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, South Korea
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Alex D, Khor HM, Chin AV, Hairi NN, Cumming RG, Othman S, Khoo S, Kamaruzzaman SB, Tan MP. Factors Associated With Falls Among Urban-Dwellers Aged 55 Years and Over in the Malaysian Elders Longitudinal Research (MELoR) Study. Front Public Health 2020; 8:506238. [PMID: 33304870 PMCID: PMC7701238 DOI: 10.3389/fpubh.2020.506238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/29/2019] [Accepted: 10/19/2020] [Indexed: 11/13/2022] Open
Abstract
Falls are major issues affecting the older population with potentially serious complications, including fractures, head injury, institutionalization, fear of falling and depression. While risk factors for falls have been established across Western Europe and North America, geographical differences in falls risk have not been well researched. We aim to examine the clinical and physical risk factors for falls in a middle-income South East Asian country. Cross-sectional data from the Malaysian Elders Longitudinal Research (MELoR) study involving 1,362 community dwelling individuals aged 55 years and above was utilized. Information on sociodemographic and medical history was obtained by computer-assisted questionnaires completed during home visits and hospital-based detailed health checks. Univariate and multivariate analyses compared non-fallers and fallers in the previous 12 months. Urinary incontinence, hearing impairment, depression, arthritis and cognitive impairment were risk factors for falls in the past 12 months after adjustment for age in our study population. Awareness about the risk factors in a population helps the design of fall prevention strategies that target specific or multiple risk factors.
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Affiliation(s)
- Deepa Alex
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Subang Jaya, Malaysia.,Division of Geriatric Medicine, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia
| | - Hui M Khor
- Division of Geriatric Medicine, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.,Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Ai V Chin
- Division of Geriatric Medicine, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.,Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Noran N Hairi
- Department of Social and Preventive Medicine, Faculty of Medicine, Julius Centre, University of Malaya, Kuala Lumpur, Malaysia
| | - Robert G Cumming
- School of Public Health, University of Sydney, Sydney, NSW, Australia
| | - Sajaratulnisah Othman
- Department of Primary Care Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Selina Khoo
- Centre for Sport and Exercise Sciences, University of Malaya, Kuala Lumpur, Malaysia
| | - Shahrul B Kamaruzzaman
- Division of Geriatric Medicine, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.,Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Maw P Tan
- Division of Geriatric Medicine, Department of Medicine, University of Malaya Medical Centre, Kuala Lumpur, Malaysia.,Ageing and Age-Associated Disorders Research Group, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia.,Department of Medical Sciences, School of Healthcare and Medical Sciences, Sunway University, Kuala Lumpur, Malaysia
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18
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Moon S, Chung HS, Yu JM, Na HR, Kim SJ, Ko KJ, Choi DK, Kwon O, Lee YG, Cho ST. Impact of urinary incontinence on falls in the older population: 2017 national survey of older Koreans. Arch Gerontol Geriatr 2020; 90:104158. [DOI: 10.1016/j.archger.2020.104158] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Revised: 06/18/2020] [Accepted: 06/18/2020] [Indexed: 12/27/2022]
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Yalcintas E, Demirci H, Aykurt Karlibel I, Turkoglu AR, Kasapoglu Aksoy M, Coban S. Geriatric giants in women over 65 years living in a rural area in Turkey. J Women Aging 2020; 33:676-682. [PMID: 32507064 DOI: 10.1080/08952841.2020.1763890] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
The aim of this study was to determine the prevalence of fall tendency, urinary incontinence, and dementia in women over 65 years of age living in rural areas of Turkey. The research was a descriptive study. Mini-Mental tests, The International Consultation of Incontinence Questionnaire (ICIQ) short forms, and Falls Behavioral Scales for the elderly were used. Urinary incontinence prevalence in women over 65 years of age living in rural areas of Bursa was 51%. Dementia frequency was calculated as 56%. A reverse and significant relationship was detected between Mini-Mental Scale and ICIQ scale scores (r = -0.12; p = .017). The Falls Behavioral Scale score was higher in the group with incontinence. The conclusion reached was that urinary incontinence and dementia are frequent among older women living in rural areas in Turkey. As diseases known as geriatric giants are associated with each other, treatment of one of them may bring protection from another negative situation.
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Affiliation(s)
- Emre Yalcintas
- Family Medicine, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Hakan Demirci
- Family Medicine, Bursa Yuksek Ihtisas Training and Research Hospital, University of Health Sciences, Bursa, Turkey
| | - Ilknur Aykurt Karlibel
- Physical Health and Rehabilitation, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Ali Riza Turkoglu
- Urology, Bursa Yuksek Ihtisas Trainig and Research Hospital, Bursa, Turkey
| | - Meliha Kasapoglu Aksoy
- Physical Health and Rehabilitation, Bursa Yuksek Ihtisas Training and Research Hospital, Bursa, Turkey
| | - Soner Coban
- Urology, Bursa Yuksek Ihtisas Trainig and Research Hospital, Bursa, Turkey
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20
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Development of a fall-risk assessment profile for community-dwelling older adults by using the National Health Interview Survey in Taiwan. BMC Public Health 2020; 20:234. [PMID: 32059657 PMCID: PMC7023681 DOI: 10.1186/s12889-020-8286-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Accepted: 01/27/2020] [Indexed: 12/19/2022] Open
Abstract
Background Falls represent a global health issue among older adults and cause a considerable burden on medical systems. In this study, a fall-risk assessment profile was developed for community-dwelling older adults. Method The data of survey participants aged > 65 years were obtained from three rounds (2005, 2009, and 2013) of the National Health Interview Survey in Taiwan. In total, 8356 older participants were included in this study. Logistic regression analyses were used to determine potential predictors associated with falls. The regression coefficients of the predictors in the final model were translated into scores (by multiplying by 5) and then summed to obtain a total risk-score for falls. A receiver operating characteristic (ROC) curve was used to evaluate the discriminative performance of the risk assessment profile. Result Self-reported falls within 1 year accounted for 19.1% of the total falls. The predictors that were included in the risk profile according to the logistic regression analysis results were as follows: female sex (adjusted odds ratio = 1.57; risk-score = 2), living alone (adjusted odds ratio = 1.56; risk-score = 2), urinary incontinence (adjusted odds ratio = 1.36; risk-score = 2), perceived unhealthiness (adjusted odds ratio = 1.32; risk-score = 1), perceived pain (adjusted odds ratio = 1.51; risk-score = 2), hospital admission in the past year (adjusted odds ratio = 2.42; risk-score = 4), low activity of daily living (ADL) scores (adjusted odds ratio = 1.29; risk-score = 1), and low mobility function scores (adjusted odds ratio = 1.68; risk-score = 3). At a total risk-score cutoff point of 6 (range 0–17), the model predicted falls with a sensitivity and specificity of 75.16 and 52.75%, respectively (area under the ROC curve = 0.70). Conclusion The fall-risk assessment profile comprising eight predictors—female sex, living alone, incontinence, perceived unhealthiness, perceived pain, hospital admission in the past year, low ADL scores, and low mobility function scores—may serve as an assessment tool for identification of older adults with a high risk of falling, and assessment results can be used to facilitate community-based intervention.
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Sayabalian A, Easton-Garrett S, Kassabian A, Kunze MB. Incontinence affects every aspect and stakeholder of an assisted living community. Geriatr Nurs 2019; 40:338-341. [PMID: 31202425 DOI: 10.1016/j.gerinurse.2019.05.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
A total incontinence management program will benefit a community's administration, nurses, caregivers, families and most importantly, residents. An incontinence program helps reduce the risk of incidences such as agitation, urinary tract infection, falls and skin complications which assisted living and memory care communities are trying to prevent. The correct evaluation tools increase the likelihood of successful outcomes because the program has to be the right program for the resident. After evaluation of the level of incontinence, the resident can then be enrolled. This article provides a practical toolkit for assessment of a resident in assisted living general or memory care populations in addition to the different types of programs a resident can enroll into after evaluation completed.
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22
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A Novel Head Mounted Display Based Methodology for Balance Evaluation and Rehabilitation. SUSTAINABILITY 2019. [DOI: 10.3390/su11226453] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In this paper, we present a new augmented reality (AR) head mounted display (HMD)-based balance rehabilitation method. This method assesses the individual’s postural stability quantitatively by measuring head movement via the inertial measurement unit sensor integrated in the AR HMD. In addition, it provides visual feedback to train through holographic objects, which interacts with the head position in real-time. We implemented applications for Microsoft HoloLens and conducted experiments with eight participants to verify the method we proposed. Participants performed each of three postural tasks three times depending on the presence or absence of augmented reality, the center of pressure (COP) displacement was measured through the Wii Balance Board, and the head displacement was measured through the HoloLens. There are significant correlations (p < 0.05) between COP and head displacement and significant differences (p < 0.05) between with/without AR feedback, although most of them were not statistically significant likely due to the small sample. Despite the results, we confirmed the applicability and potential of the AR HMD-based balance rehabilitation method we proposed. We expect the proposed method could be used as a convenient and effective rehabilitation tool for both patients and therapists in the future.
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Le Berre M, Morin M, Corriveau H, Hamel M, Nadeau S, Filiatrault J, Dumoulin C. Characteristics of Lower Limb Muscle Strength, Balance, Mobility, and Function in Older Women with Urge and Mixed Urinary Incontinence: An Observational Pilot Study. Physiother Can 2019; 71:250-260. [PMID: 31719721 DOI: 10.3138/ptc.2018-30] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Purpose: After the age of 65, urinary incontinence (UI) occurs in one of every two women. A positive correlation between falls and urgency UI (UUI) or mixed UI (MUI) has also been identified. However, lower extremity impairments in older women with UUI or MUI have not been thoroughly investigated. The primary goal of this study was to compare lower limb strength, balance, mobility, and function in older women with and without UUI or MUI. The secondary goal was to evaluate the association between these measurements and UI severity. Method: A total of 40 older women with and without UUI or MUI completed standardized tests for lower limb strength (knee flexor or extensor dynamometry, 30-second sit-to-stand test), balance (single-leg stance test, Four Square Step Test, Activities-specific Balance Confidence questionnaire), mobility (10-metre walk test, 6-minute walk test), and function (Human Activity Profile questionnaire, 12-Item Short Form Health Survey). Results: Significant differences in balance and mobility were observed between the two groups. Women with UI had shorter single-leg stance times, lower balance confidence scores, and slower gait speeds. Conclusions: The results from this pilot study suggest that high-functioning older women with UUI or MUI have balance and mobility impairments. More studies are needed to confirm these results. By reporting power calculations for sample size, this pilot study provides a useful basis on which to design and conduct larger studies.
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Affiliation(s)
- Mélanie Le Berre
- Institut Universitaire de Gériatrie de Montréal.,School of Rehabilitation, Université de Montréal
| | - Mélanie Morin
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Que
| | - Hélène Corriveau
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Que
| | - Mathieu Hamel
- School of Rehabilitation, Université de Sherbrooke, Sherbrooke, Que
| | - Sylvie Nadeau
- School of Rehabilitation, Université de Montréal.,Pathokinesiology Laboratory, Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal, Montreal
| | - Johanne Filiatrault
- Institut Universitaire de Gériatrie de Montréal.,School of Rehabilitation, Université de Montréal
| | - Chantale Dumoulin
- Institut Universitaire de Gériatrie de Montréal.,School of Rehabilitation, Université de Montréal
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Giraldo‐Rodríguez L, Agudelo‐Botero M, Mino‐León D, Álvarez‐Cisneros T. Epidemiology, progression, and predictive factors of urinary incontinence in older community‐dwelling Mexican adults: Longitudinal data from the Mexican Health and Aging Study. Neurourol Urodyn 2019; 38:1932-1943. [DOI: 10.1002/nau.24096] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 06/17/2019] [Indexed: 11/09/2022]
Affiliation(s)
- Liliana Giraldo‐Rodríguez
- Demographic Epidemiology and Social Determinants DepartmentNational Institute of Geriatrics Mexico City Mexico
| | - Marcela Agudelo‐Botero
- Politics, Population and Health Research CenterSchool of Medicine, National Autonomous University of Mexico Mexico City Mexico
| | - Dolores Mino‐León
- Clinical Epidemiology Research Unit, National Medical Center "Siglo XXI"Mexican Social Security Institute Mexico City Mexico
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Yang YC, Lin MH, Wang CS, Lu FH, Wu JS, Cheng HP, Lin SI. Geriatric syndromes and quality of life in older adults with diabetes. Geriatr Gerontol Int 2019; 19:518-524. [PMID: 30957935 DOI: 10.1111/ggi.13654] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2018] [Revised: 01/28/2019] [Accepted: 02/15/2019] [Indexed: 12/18/2022]
Abstract
AIM To describe geriatric syndromes and their relationships with quality of life in older adults with diabetes. METHODS Community-dwelling older adults (aged >60 years) with diabetes (n = 316) participated in the present study. Eight geriatric syndromes, including polypharmacy (number of medications), pain (Brief Pain Inventory), urinary incontinence (International Consultation on Incontinence Questionnaire), sleep disturbance (hours of sleep), lower cognitive level (Mini-Mental State Examination), falls, depressive symptoms (Geriatric Depression Scale short form) and functional limitation (Barthel Index and Instrumental Activity of Daily Living), were assessed. The WHOQOL-BREF Taiwan version was used to measure physical, psychological, social and environmental domains of quality of life. RESULTS Polypharmacy was the most common geriatric syndrome (46.6%), followed by pain (41.5%). Participants with any of the geriatric syndromes, except for polypharmacy and sleep disturbance, had significantly poorer quality of life than those without. The Geriatric Depression Scale score was the only common and significant contributor to all four domains of quality of life, explaining 16~29% of the variance. Number of medications, pain level and cognitive level were also significant contributors, although they explained a small amount (<5%) of the variance. The number of geriatric syndromes (mode = 2) was significantly correlated with all four domains of quality of life (partial correlation r = -0.278~0.460, all P < 0.001). CONCLUSIONS Geriatric syndromes, especially polypharmacy and pain, were common among older adults with diabetes. A greater number of geriatric syndromes or a higher Geriatric Depression Scale score were associated with poorer quality of life. Further studies focusing on combinations of different geriatric syndromes or comorbidities are required. Geriatr Gerontol Int 2019; 19: 518-524.
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Affiliation(s)
- Yi-Ching Yang
- Department of Family Medicine, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan.,Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Ming-Hsing Lin
- Department of Family Medicine, Tainan Hospital, Ministry of Health and Welfare, Tainan, Taiwan
| | - Chong-Shan Wang
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Alian Health Clinic, Kaohsiung County, Taiwan
| | - Feng-Hwa Lu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Jin-Shang Wu
- Department of Family Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Hui-Ping Cheng
- Institute of Allied Health Science, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sang-I Lin
- Institute of Allied Health Science, College of Medicine, National Cheng Kung University, Tainan, Taiwan.,Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
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The Association Between Overactive Bladder and Falls and Fractures: A Systematic Review. Adv Ther 2018; 35:1831-1841. [PMID: 30255417 PMCID: PMC6223978 DOI: 10.1007/s12325-018-0796-8] [Citation(s) in RCA: 31] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2018] [Indexed: 11/18/2022]
Abstract
Introduction Urinary symptoms are associated with an increased risk of falls, but few studies have focused on patients with overactive bladder (OAB). This study aimed to synthesize estimates of the risk of falls and fractures in patients with OAB. Methods Medline, EMBASE, the Cumulative Index to Nursing and Allied Health Literature, and Scopus were systematically searched for observational studies that focused on patients with OAB. When available, data from a non-OAB comparison sample were included. Double independent review and data extraction were performed. Falls and fractures data were summarized by unadjusted and adjusted risks, and percent attributable risk (PAR) of falls and fractures associated with OAB. Results Fifteen studies were included in the analyses. The proportion of patients with OAB experiencing at least one fall over a year ranged from 18.9% to 50.0%, and the proportion of patients with OAB experiencing recurrent or serious falls ranged from 10.2% to 56.0%. In studies that included a non-OAB comparison sample, a higher risk of falls was observed in patients with OAB compared to those without. A significantly increased (1.3- to 2.3-fold) adjusted OAB-associated risk of falls was reported, while unadjusted PARs for OAB associated falls ranged from 3.7% to 15.5%. Risk was higher among women and those 65 years of age or older. While analysis of fractures showed elevated point estimates, most studies were underpowered to detect a statistically significant difference between groups. Conclusions Evidence from the published literature clearly demonstrates the importance of OAB and its symptoms as risk factors for falls and fractures. Funding Astellas. Electronic supplementary material The online version of this article (10.1007/s12325-018-0796-8) contains supplementary material, which is available to authorized users.
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Herrewegh A, Vork L, Eurelings E, Leue C, Kruimel J, van Koeveringe G, Vrijens D. The development of a patient-reported outcome measure for real-time symptom assessment in a population with functional urologic complaints-A focus group study. Neurourol Urodyn 2018; 37:2893-2903. [PMID: 30187953 DOI: 10.1002/nau.23808] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2018] [Accepted: 08/09/2018] [Indexed: 12/12/2022]
Abstract
AIMS In the current diagnostic process for overactive bladder syndrome (OAB), biased retrospective questionnaires are often used. There is a need for a new assessment tool that embraces the heterogeneity of the OAB complex. A momentary assessment tool, the Experience Sampling Method (ESM) is promising, capturing random repetitive measurements during the day in the context of daily life and is capable to measure potential contextual triggers and psychological aspects. A focus group study was set up to evaluate which items should be implemented in a urological ESM. METHODS Focus group interviews were arranged, to assess the suitability and comprehensibility of a newly developed urological patient-reported outcome measurement (PROM), "Uromate." "Uromate" was created based on ESM literature. A multidisciplinary expert meeting was conducted to gain consensus on item relevance. RESULTS The initial ESM questionnaire contained 58 items, but was eventually reduced to 39 items after focus group sessions and expert meeting. Thirty-seven items are repeated questions, including three gender-dependent items. Two items are one-time questions about the use of incontinence material. Additionally, a morning questionnaire was included. Depending on the symptom pattern, a minimum of 26 items and a maximum of 36 items will be repeatedly assessed with "Uromate." CONCLUSION There is a need for a modern assessment tool for OAB which overcomes the limitations of today's retrospective questionnaires. Therefore, a urological ESM tool, the "Uromate," is being developed as a PROM, following the FDA PROM development guidelines, to measure real-time symptoms in the context of daily life.
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Affiliation(s)
- Alexandra Herrewegh
- Department of Urology, Maastricht University Medical Center+, Maastricht, The Netherlands.,Pelvic Care Center, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Lisa Vork
- Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Eline Eurelings
- Department of Psychiatry and Medical Psychology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Carsten Leue
- Pelvic Care Center, Maastricht University Medical Center+, Maastricht, The Netherlands.,Department of Psychiatry and Medical Psychology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Joanna Kruimel
- Pelvic Care Center, Maastricht University Medical Center+, Maastricht, The Netherlands.,Division of Gastroenterology-Hepatology, Department of Internal Medicine, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Gommert van Koeveringe
- Department of Urology, Maastricht University Medical Center+, Maastricht, The Netherlands.,Pelvic Care Center, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Desiree Vrijens
- Department of Urology, Maastricht University Medical Center+, Maastricht, The Netherlands.,Pelvic Care Center, Maastricht University Medical Center+, Maastricht, The Netherlands
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If We Don't Ask, They Won't Tell: Screening for Urinary and Fecal Incontinence by Primary Care Providers. J Am Board Fam Med 2018; 31:774-782. [PMID: 30201674 PMCID: PMC6170156 DOI: 10.3122/jabfm.2018.05.180045] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Revised: 04/17/2018] [Accepted: 04/22/2018] [Indexed: 12/12/2022] Open
Abstract
BACKGROUND More than half of older adults experience urinary (UI) or fecal incontinence (FI), but the majority have never discussed symptoms with health care providers. Little is known about primary care providers' (PCPs') screening for UI and FI. METHODS We conducted a cross-sectional electronic survey of PCPs within a Midwest academic institution to ascertain and compare PCPs' beliefs, attitudes, and behaviors regarding screening and treatment for UI and FI; determine factors associated with screening for FI; and identify potential barriers to and facilitators of FI screening and treatment. RESULTS Among 154 PCPs, the screening rate for UI (75%) was more than double that for FI (35%; P < .001). PCPs believed that both UI and FI screening were important but felt better informed to treat UI (P < .001). Screening for FI was associated with UI screening (OR, 11.27; 95% CI, 4.9-26.0; P < .001); feeling informed to treat FI (OR, 10.21; 95% CI, 1.2-90.0; P = .01); screening verbally (OR, 3.9; 95% CI, 1.9-8.0; P < .001); perceiving screening as important (OR, 3.7; 95% CI, 1.8-7.4; P < .001); using the term, "accidental bowel leakage" (OR, 2.9; 95% CI, 1.2-6.7; P = .02) or "bowel control issues" (OR, 2.2; 95% CI, 1.1-4.5; P = .03); and being a resident (OR, 0.37; 95% CI, 0.16-0.82; P = .02). PCPs reported high interest in patient and provider educational materials about UI and FI. CONCLUSIONS Most PCPs screen for UI but not FI. High reported interest in educational materials, coupled with high reported rates of perceived importance of screening for UI and FI, suggests that PCPs welcome informative interventions to streamline diagnosis and treatment.
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Lee PY, Tsai YJ, Liao YT, Yang YC, Lu FH, Lin SI. Reactive balance control in older adults with diabetes. Gait Posture 2018; 61:67-72. [PMID: 29306146 DOI: 10.1016/j.gaitpost.2017.12.030] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/21/2017] [Revised: 12/28/2017] [Accepted: 12/29/2017] [Indexed: 02/02/2023]
Abstract
Diabetes mellitus is a major health problem for older adults worldwide and could be associated with impaired ability to recover balance after postural disturbances. This study compared reactive balance control in three groups of adults, young (YA), healthy non-diabetes older (nonDM-OA) and diabetes older (DM-OA). Twenty participants in each group completed a series of vision, plantar cutaneous sensitivity, grip power and lower limb strength tests. In the reactive balance test, participants stood on a force platform and used the dominant hand to pull the handle of a cord that could be suddenly released to create an imbalancing force. The anteroposterior (AP) and mediolateral (ML) motion of the center of pressure (COP) immediately after the sudden release was calculated to represent the level of imbalance experienced by the participants. Regression analysis entering big toe plantar sensitivity and grip power as independent variable was conducted for COP range for the three groups separately. The results showed that, except for the knee extensor, DM-OA had significantly poorer muscle strength and plantar sensitivity, and greater COP ML motion than YA and nonDM-OA. DM-OA also had significantly greater COP AP motion than YA. Grip power alone and together with plantar sensitivity explained a significant amount of variance in the AP and ML COP motion respectively (r2 = 0.334 and 0.582, respectively) for DM-OA. These findings indicated that diabetes in older adults was associated with declines in reactive balance control, and these changes may be related to muscle weakness and plantar insensitivity.
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Affiliation(s)
- Pei-Yun Lee
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ju Tsai
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yu-Ting Liao
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Yi-Ching Yang
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Fen-Hwa Lu
- Department of Family Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
| | - Sang-I Lin
- Department of Physical Therapy, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
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Sohn K, Lee CK, Shin J, Lee J. Association between Female Urinary Incontinence and Geriatric Health Problems: Results from Korean Longitudinal Study of Ageing (2006). Korean J Fam Med 2018; 39:10-14. [PMID: 29383206 PMCID: PMC5788839 DOI: 10.4082/kjfm.2018.39.1.10] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2016] [Revised: 08/23/2016] [Accepted: 09/09/2016] [Indexed: 11/21/2022] Open
Abstract
Background Urinary incontinence (UI) is highly prevalent in the aging population. UI is one of the most common geriatric syndromes and affects overall health, quality of life, and economical burden in patients. The aims of this study were to investigate the characteristics of patients with UI and to assess its association with other geriatric health problems. Methods We used data from the Korean Longitudinal Study of Ageing obtained in 2006. Among the 10,254 individuals aged 45 years and older, we analyzed data from 2,418 women aged 65 years and older. Data were obtained using questionnaires for UI, comorbidities, and lifestyle factors. Results Among the 2,418 women aged 65 years and older, 506 (20.9%) had UI. Cerebrovascular disease (odds ratio [OR], 2.02; 95% confidence interval [CI], 1.26 to 3.23), arthritis (OR, 1.44; 95% CI, 1.18 to 1.77), and fear of falling (OR, 1.62; 95% CI, 1.18 to 2.22) were significantly associated with UI, while chronic lung disease, psychiatric disease, difficulty in daily living due to visual and hearing problems, and experiencing a fall in the last 2 years were not associated with UI. Conclusion Cerebrovascular disease, arthritis, and especially fear of falls were significantly associated with UI in elderly Korean women.
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Affiliation(s)
- Kyungjin Sohn
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Chang Ki Lee
- Department of Urology, Pyeongchang Health Center and County Hospital, Pyeongchang, Korea
| | - Jinyoung Shin
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Jungkwon Lee
- Department of Family Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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Junqueira JB, Santos VLCDG. Urinary incontinence in hospital patients: prevalence and associated factors. Rev Lat Am Enfermagem 2018; 25:e2970. [PMID: 29319744 PMCID: PMC5768210 DOI: 10.1590/1518-8345.2139.2970] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Accepted: 09/22/2017] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVES to analyze the prevalence of urinary incontinence and its associated factors in hospital patients. METHOD this is a cross-sectional epidemiological study whose data were collected using the instruments Sociodemographic and Clinical Data, Characteristics of Urinary Leakage and International Consultation on Incontinence Questionnaire - Short Form. Prevalence was surveyed on a single day for four consecutive months. Data were analyzed using Chi-square test, Fisher's exact test, Student t-test, Mann-Whitney test and logistic regression (forward stepwise). RESULTS the final sample consisted of 319 hospital adults (57.1% female), mean age of 47.9 years (SD=21.1). The prevalence of urinary incontinence was 22.9% (28% in women and 16.1% in men) and the associated factors were: female sex (OR=3.89), age (OR=1.03), asthma (OR=3.66), use of laxatives (OR=3.26), use of diaper during the evaluation (OR=2.75), use of diaper at home (OR=10.29), and use of diaper at some point during the hospital stay (OR=6.74). CONCLUSION the findings of this study differ from those found in the scarce existing literature on the subject in hospital patients. There is a need for previous studies such as this before proposing the implementation of preventive and therapeutic actions during the hospital stay.
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Affiliation(s)
- Jaqueline Betteloni Junqueira
- Especialist, Stomal Therapy Especialization, MSc, Escola de Enfermagem, Universidade de São Paulo, São Paulo, SP, Brazil, Nursing, Medic Clinical, Hospital Universitário da Universidade de São Paulo, São Paulo, SP, Brazil
| | - Vera Lúcia Conceição de Gouveia Santos
- Post-Doctoral degree, Associate Professor, Departamento de Enfermagem Médico-Cirúrgica, Escola de Enfermagem da Universidade de São Paulo, São Paulo, SP, Brazil
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Abstract
Urinary incontinence (UI) in older adult patients poses a risk for complications and hospitalization. The aim of this quality improvement project was to develop and implement a protocol to promote continence in older adults with UI. Data were collected from a convenience sample of 26 participants, 80 years of age or older, in a midsize suburban home care agency. All participants were diagnosed with UI as documented in the Outcomes and Assessment Information Set (OASIS). OASIS question M1610 was used to identify patients with UI status, and M1650 was used, to identify UI frequency. The outcomes for these questions were assessed to examine change over time in UI status and frequency. Eligible patients completed a 3-day bladder diary, then patient education was conducted on UI, risk factors, bladder training, pelvic floor exercises, and hydration/nutrition parameters. Patients then completed 3-day bladder diaries postintervention. At pretest, 100% of the participants were incontinent. At posttest, 24 participants (92.3%) were incontinent. The results suggest that the median frequency of UI declined overtime from 2 (range: 1-4) at pretest to 1 (range: 0-4) at posttest. This decline was statistically significant (z = -3.83; p < .001). Future studies should examine changes in the UI complications and hospitalization rates.
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Affiliation(s)
- Maureen Albertson
- Maureen Albertson, DNP, RN, is a Compliance Officer/Nurse Educator/Quality Assurance, Millenium Home Care, Port Charlotte, Florida
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Schluter PJ, Arnold EP, Jamieson HA. Falls and hip fractures associated with urinary incontinence among older men and women with complex needs: A national population study. Neurourol Urodyn 2017; 37:1336-1343. [DOI: 10.1002/nau.23442] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2017] [Accepted: 09/29/2017] [Indexed: 12/26/2022]
Affiliation(s)
- Philip J. Schluter
- School of Health SciencesUniversity of Canterbury ‐ Te Whare Wānanga o WaitahaChristchurchNew Zealand
- School of NursingMidwifery and Social WorkThe University of QueenslandBrisbaneAustralia
| | - Edwin P. Arnold
- Department of SurgeryUniversity of OtagoChristchurchNew Zealand
| | - Hamish A. Jamieson
- Department of MedicineUniversity of OtagoChristchurchNew Zealand
- Older Person's HealthCanterbury District Health BoardChristchurchNew Zealand
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Karabulut A, Simavlı S, Demirtaş Ö, Ök N, Güngör HR, Zümrütbaş A. Evaluation of overactive bladder and nocturia as a risk factor for hip fracture in climacteric women: a matched pair case control study. J OBSTET GYNAECOL 2017; 38:252-256. [PMID: 28903631 DOI: 10.1080/01443615.2017.1349082] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
The aim of this study was to investigate whether overactive bladder (OAB) influences hip fractures in climacteric women by comparing the frequency of OAB and nocturia symptoms in patients with hip fractures and their age-matched controls in pre-fracture period. A total of 30 climacteric patients with a history of hip fracture were compared to a control group of 51 women in terms of OAB, nocturia and nocturia-QoL. A questionnaire composed of structured questions and Turkish validated versions of the specific questionnaires for OAB, OAB-Quality of Life (OAB-q) and nocturia-QoL was directed to the two groups. We did not detect statistically relevant differences between the groups for the presence or severity of OAB and OAB-q (p > .05). However, Nocturia-QoL was worse in the group with hip fracture (p = .022). Overactive bladder has no contribution to the overall risk of hip fracture, whereas, the severity of nocturia seems to play a role as a risk factor in the formation of hip fracture. Impact statement What is already known on this subject: Hip fracture is associated with high morbidity, mortality and the cost. Prevention of hip fracture is a high priority for the patients, physicians and the public health. Several studies and consensus opinions have investigated the risk factors for the hip fractures. What the results of this study add: Although urinary symptoms were not evaluated in previous studies as a risk factor, desire of urination makes people stand up and move to their toilet, and may put them in a hurry if it is sudden and uncontrollable one. Therefore, we hypothesised that overactive bladder (OAB) and nocturia may be a risk factor in the formation of hip fractures. Our study showed that Nocturia Quality of Life is worse in patients with the hip fracture. Therefore, overactive bladder may not have a role on the overall risk of hip fracture, but the severity of nocturia seems as a risk factor in the fracture process. What the implications are of these findings for clinical practice and/or further research: The getting up from the bed would probably be harder than getting up from a chair in elderly, and life style modifications such as illumination bedroom and organisation of living place may be helpful to minimise the risks.
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Affiliation(s)
- Aysun Karabulut
- a Department of Obstetrics and Gynecology , Pamukkale University Medical School , Denizli , Turkey
| | - Serap Simavlı
- a Department of Obstetrics and Gynecology , Pamukkale University Medical School , Denizli , Turkey
| | - Ömer Demirtaş
- a Department of Obstetrics and Gynecology , Pamukkale University Medical School , Denizli , Turkey
| | - Nusret Ök
- b Department of Orthopedics , Pamukkale University Medical School , Denizli , Turkey
| | - Harun Reşit Güngör
- b Department of Orthopedics , Pamukkale University Medical School , Denizli , Turkey
| | - Ali Zümrütbaş
- c Department of Urology , Pamukkale University Medical School , Denizli , Turkey
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Starr JM. Giant steps forward. Age Ageing 2017. [PMID: 28633430 DOI: 10.1093/ageing/afx097] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- John M Starr
- Alzheimer Scotland Dementia Research Centre, University of Edinburgh, Edinburgh, EH8 9JZ, UK
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Jamieson HA, Schluter PJ, Pyun J, Arnold T, Scrase R, Nisbet-Abey R, Mor V, Deely JM, Gray L. Fecal Incontinence Is Associated With Mortality Among Older Adults With Complex Needs: An Observational Cohort Study. Am J Gastroenterol 2017; 112:1431-1437. [PMID: 28762377 DOI: 10.1038/ajg.2017.200] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/25/2016] [Accepted: 05/30/2017] [Indexed: 12/11/2022]
Abstract
OBJECTIVES Fecal incontinence (FI) is a problem in growing older populations. Validating a suspected association between FI and mortality in community dwelling older adults could lead to improved planning for and management of the increasing complex older population. In a large cohort of New Zealand older adults, we assessed the prevalence of FI, urinary incontinence (UI), combined FI and UI, and their associations with mortality. METHODS This study consisted of a retrospective analysis of international standardized geriatric assessment-home care (InterRAI-HC) data from community-dwelling adults aged 65 years or older, who met the criteria required for the InterRAI-HC, having complex needs and being under consideration for residential care. The prevalence of UI and FI was analyzed. Data were adjusted for demography and 25 confounding factors. Mortality was the primary outcome measure. RESULTS The total cohort consisted of 41,932 older adults. Both UI and FI were associated with mortality (P<0.001), and risk of mortality increased with increased frequency of incontinence. In the adjusted model, FI remained significantly related to survival (P<0.001), whereas UI did not (P=0.31). Increased frequency of FI was associated with an increased likelihood of death (hazard ratio 1.28). CONCLUSIONS This large national study is the first study to prove a statistically significant relationship between FI and mortality in a large, old and functionally impaired community. These findings will help improve the management of increasingly complex older populations.
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Affiliation(s)
- Hamish A Jamieson
- Department of Medicine, University of Otago-Christchurch, Christchurch, New Zealand.,Older Persons Inpatient Health Services, Burwood Hospital, Christchurch, New Zealand
| | - Philip J Schluter
- Department of Health Sciences, University of Canterbury, Christchurch, New Zealand.,School of Nursing, Midwifery and Social Work, University of Queensland, Brisbane, Queensland, Australia
| | - Juno Pyun
- Department of Medicine, University of Otago-Christchurch, Christchurch, New Zealand
| | - Ted Arnold
- Department of Surgery, University of Otago-Christchurch, Christchurch, New Zealand
| | - Richard Scrase
- Canterbury District Health Board, Christchurch, New Zealand
| | - Rebecca Nisbet-Abey
- Department of Medicine, University of Otago-Christchurch, Christchurch, New Zealand
| | - Vincent Mor
- Department of Health Services, Policy and Practice, Brown University, Providence, Rhode Island, USA
| | - Joanne M Deely
- Department of Medicine, University of Otago-Christchurch, Christchurch, New Zealand.,Canterbury District Health Board, Christchurch, New Zealand
| | - Len Gray
- Academic Unit of Geriatric Medicine, University of Queensland, Brisbane, Queensland, Australia
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Female double incontinence: prevalence, incidence, and risk factors from the SABE (Health, Wellbeing and Aging) study. Int Urogynecol J 2017. [PMID: 28620790 DOI: 10.1007/s00192-017-3365-9] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Double Incontinence (DI) is incontinence of urine and stool and is an extreme manifestation of pelvic floor dysfunction. The objective of this study was to estimate the prevalence and incidence of DI and the risk factors in elderly women in São Paulo, Brazil. METHODS This was a prospective study in women aged 65 years or older evaluated in 2006 and re-evaluated in 2010. The sample was selected by two-phase stratified sampling with replacement and probability proportional to size. The likelihood ratio test was performed and Cox regression curves were generated to evaluate the equality of survival. Poisson's regression was used to evaluate risk factors. RESULTS This is the first study on the incidence of DI in elderly women. A total of 864 elderly women were interviewed in 2006. The prevalence rate of DI was 4.9%. The incidence rate of DI in the period between 2006 and 2010 was 13.8/1,000 person-years. Associated factors were the presence of chronic obstructive pulmonary disease, hypertension, difficulty with basic activities of daily living (BADL) and instrumental activities of daily living (IADL), polypharmacy and falls in the last year. Poisson's regression analysis showed that falls in the last year and difficulty with at least three IADL were risk factors for DI. CONCLUSIONS The incidence of DI seems to be high in this population. Falls in the last year and difficulty with at least three IADL were identified as risk factors. Preventive measures must be implemented with public health policies to prevent increases in DI.
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Gibson W, Hunter KF, Camicioli R, Booth J, Skelton DA, Dumoulin C, Paul L, Wagg A. The association between lower urinary tract symptoms and falls: Forming a theoretical model for a research agenda. Neurourol Urodyn 2017; 37:501-509. [PMID: 28471525 DOI: 10.1002/nau.23295] [Citation(s) in RCA: 51] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2017] [Accepted: 03/31/2017] [Indexed: 11/06/2022]
Abstract
BACKGROUND There is a well-recognised association between falls and lower urinary tract symptoms (LUTS) in older adults, with estimates of odd ratios for falls in the presence of LUTS ranging between 1.5 and 2.3. Falls and LUTS are both highly prevalent among older people and both are markers of frailty, with significant associated morbidity, mortality, and healthcare resource cost. This association is not well examined or explained in the literature. AIMS We aimed to outline current knowledge of the association between falls and lower urinary tract symptoms and suggest a research program to further investigate this. MATERIALS AND METHODS A consensus conference of experts in the field was convened to review the current literature and brainstorm potential future investigative avenues. RESULTS AND DISCUSSION Despite the recognition of this association, there has been little research to examine its potential causes, and no intervention trial has established if reducing LUTS or urinary incontinence can reduce the risk of falls. The commonly held assumption that urgency causes falls through rushing to the toilet is likely incorrect. Falls and LUTS are both symptoms of frailty and have many common causes. Gait, balance, and continence are all processes requiring cognitive input, and the concept of dual tasking may be a further link. CONCLUSION The significant association between lower urinary tract symptoms and falls is currently unexplained, and further research into the potential causes of this association is needed.
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Affiliation(s)
- William Gibson
- Division of Geriatric Medicine, University of Alberta, Edmonton, Alberta, Canada
| | - Kathleen F Hunter
- Faculty of Nursing, University of Alberta, Edmonton, Alberta, Canada
| | - Richard Camicioli
- Division of Neurology, University of Alberta, Edmonton, Alberta, Canada
| | - Joanne Booth
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Dawn A Skelton
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | | | - Lorna Paul
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Adrian Wagg
- Division of Geriatric Medicine, University of Alberta, Edmonton, Alberta, Canada
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Chmielewska D, Stania M, Słomka K, Błaszczak E, Taradaj J, Dolibog P, Juras G. Static postural stability in women with stress urinary incontinence: Effects of vision and bladder filling. Neurourol Urodyn 2017; 36:2019-2027. [PMID: 28185317 DOI: 10.1002/nau.23222] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Revised: 12/27/2016] [Accepted: 01/05/2017] [Indexed: 12/18/2022]
Abstract
AIMS This case-control study was designed to compare static postural stability between women with stress urinary incontinence and continent women and it was hypothesized that women with incontinence aged around 50 years also have balance disorders. METHODS Eighteen women with incontinence and twelve women without incontinence aged 50-55 years participated in two 60-s trials of each of four different testing conditions: eyes open/full bladder, eyes open/empty bladder, eyes closed/full bladder, eyes closed/empty bladder. The center of foot pressure (COP): sway range, root mean square, velocity (in the antero-posterior and medio-lateral directions), and COP area were recorded. The stabilograms were decomposed into rambling and trembling components. RESULTS The groups of women with and without incontinence differed during the full bladder condition in antero-posterior COP sway range, COP area, and rambling trajectory (range in the antero-posterior and medio-lateral directions, root mean square in the antero-posterior and medio-lateral directions and velocity in the antero-posterior direction). CONCLUSION The women with incontinence had more difficulty controlling their postural balance than continent women while standing with a full bladder. Therefore, developing therapeutic management focused on strengthening the women's core muscles and improving their postural balance seems advisable.
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Affiliation(s)
- Daria Chmielewska
- Faculty of Physiotherapy, Department of Physiotherapy Basics, Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Magdalena Stania
- Faculty of Physiotherapy, Department of Physiotherapy Basics, Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Kajetan Słomka
- Department of Human Motor Behavior, Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Edward Błaszczak
- Department and Faculty of Medical Biophysics, Medical University of Silesia, Katowice, Poland
| | - Jakub Taradaj
- Faculty of Physiotherapy, Department of Physiotherapy Basics, Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
| | - Patrycja Dolibog
- Department and Faculty of Medical Biophysics, Medical University of Silesia, Katowice, Poland
| | - Grzegorz Juras
- Department of Human Motor Behavior, Jerzy Kukuczka Academy of Physical Education, Katowice, Poland
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Bladder Control Problems in Elders. TOPICS IN GERIATRIC REHABILITATION 2016. [DOI: 10.1097/tgr.0000000000000118] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Noguchi N, Chan L, Cumming RG, Blyth FM, Naganathan V. A systematic review of the association between lower urinary tract symptoms and falls, injuries, and fractures in community-dwelling older men. Aging Male 2016; 19:168-174. [PMID: 27068237 DOI: 10.3109/13685538.2016.1169399] [Citation(s) in RCA: 34] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Lower urinary tract symptoms (LUTS) have been associated with falls in studies either exclusively or predominantly of women. It is, therefore, less clear if LUTS are risk factors for falls in men. METHODS We conducted a systematic review of the literature on the association between LUTS and falls, injuries, and fractures in community-dwelling older men. Medline, Embase, and Cinahl were searched for any type of observational study that has been published in a peer-reviewed journal in English language. Studies were excluded if they did not report male-specific data or targeted specific patient populations. Results were summarized qualitatively. RESULTS Three prospective cohort studies and six cross-sectional studies were identified. Incontinence, urgency, nocturia, and frequency were consistently shown to have weak to moderate association with falls (the point estimates of odds ratio and relative risk ranged from 1.31 to 1.67) in studies with low risk of bias for confounding. Only frequency was shown to be associated with fractures. CONCLUSIONS Urinary incontinence and lower urinary tract storage symptoms are associated with falls in community-dwelling older men. The circumstances of falls in men with LUTS need to be investigated to generate hypotheses about what types of interventions may be effective in reducing falls.
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Affiliation(s)
- Naomi Noguchi
- a Centre for Education and Research on Ageing and Ageing and Alzheimer's Institute, Concord Hospital, University of Sydney , Concord , NSW , Australia
| | - Lewis Chan
- b Department of Urology , Concord Hospital, University of Sydney , Concord , NSW , Australia , and
| | - Robert G Cumming
- a Centre for Education and Research on Ageing and Ageing and Alzheimer's Institute, Concord Hospital, University of Sydney , Concord , NSW , Australia
- c School of Public Health, University of Sydney , Sydney , NSW , Australia
| | - Fiona M Blyth
- a Centre for Education and Research on Ageing and Ageing and Alzheimer's Institute, Concord Hospital, University of Sydney , Concord , NSW , Australia
| | - Vasi Naganathan
- a Centre for Education and Research on Ageing and Ageing and Alzheimer's Institute, Concord Hospital, University of Sydney , Concord , NSW , Australia
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Abstract
Few studies have focused on falls among home care (HC) clients with neurological conditions. This study identified factors that increase risk of falling among HC clients with no recent history of falls, and explored whether risk profiles varied among those with dementia or parkinsonism compared to those without selected neurological conditions. A retrospective cohort design was used and analysis of data from community-based HC clients across Ontario was conducted on a sample of ambulatory clients with dementia, parkinsonism, or none of the selected neurological conditions. Data were obtained from the Resident Assessment Instrument for HC (RAI-HC) assessment. The outcome used in multivariable analyses was whether clients fell during follow-up. Unsteady gait was a strong predictor of falls across all three groups. Co-morbid parkinsonism most strongly predicted falls in the dementia group. Clients with borderline intact to mild cognitive impairment had higher odds of falling within the parkinsonism and comparison groups.
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Chari SR, Smith S, Mudge A, Black AA, Figueiro M, Ahmed M, Devitt M, Haines TP. Feasibility of a stepped wedge cluster RCT and concurrent observational sub-study to evaluate the effects of modified ward night lighting on inpatient fall rates and sleep quality: a protocol for a pilot trial. Pilot Feasibility Stud 2016; 2:1. [PMID: 27965823 PMCID: PMC5154083 DOI: 10.1186/s40814-015-0043-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Accepted: 12/22/2015] [Indexed: 01/09/2023] Open
Abstract
Background Falls among hospitalised patients impose a considerable burden on health systems globally and prevention is a priority. Some patient-level interventions have been effective in reducing falls, but others have not. An alternative and promising approach to reducing inpatient falls is through the modification of the hospital physical environment and the night lighting of hospital wards is a leading candidate for investigation. In this pilot trial, we will determine the feasibility of conducting a main trial to evaluate the effects of modified night lighting on inpatient ward level fall rates. We will test also the feasibility of collecting novel forms of patient level data through a concurrent observational sub-study. Methods/design A stepped wedge, cluster randomised controlled trial will be conducted in six inpatient wards over 14 months in a metropolitan teaching hospital in Brisbane (Australia). The intervention will consist of supplementary night lighting installed across all patient rooms within study wards. The planned placement of luminaires, configurations and spectral characteristics are based on prior published research and pre-trial testing and modification. We will collect data on rates of falls on study wards (falls per 1000 patient days), the proportion of patients who fall once or more, and average length of stay. We will recruit two patients per ward per month to a concurrent observational sub-study aimed at understanding potential impacts on a range of patient sleep and mobility behaviour. The effect on the environment will be monitored with sensors to detect variation in light levels and night-time room activity. We will also collect data on possible patient-level confounders including demographics, pre-admission sleep quality, reported vision, hearing impairment and functional status. Discussion This pragmatic pilot trial will assess the feasibility of conducting a main trial to investigate the effects of modified night lighting on inpatient fall rates using several new methods previously untested in the context of environmental modifications and patient safety. Pilot data collected through both parts of the trial will be utilised to inform sample size calculations, trial design and final data collection methods for a subsequent main trial. Trial registration Australian New Zealand Clinical Trials Register (ANZCTR): ACTRN12614000615684 (cluster RCT) and ACTRN12614000616673 (observational sub-study). Date Registered: 10 June 2014 (both studies). Protocol version: 1.2 (Dated: 01 June 2014) Anticipated completion: September 2015 Role of Trial Sponsor: The named sponsor for this investigator-initiated trial was the Director of the Royal Brisbane and Women’s Hospital (RBWH) Safety and Quality Unit (Therese Lee, Phone: +61 7 3646 8111). The principal investigators, SC and MA, are employed by the RBWH Safety and Quality Unit. The trial sponsor has no involvement in any aspects of study design, conduct or decision to submit the report for publication. AM and MD are employed by other departments in the same organisation.
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Affiliation(s)
- Satyan R Chari
- Physiotherapy Department, Monash University, Melbourne, Victoria Australia ; Safety and Quality Unit, Metro North Hospital and Health Service (MNHHS), Royal Brisbane and Women's Hospital, Brisbane, Queensland Australia
| | - Simon Smith
- Centre for Accident Research and Road Safety-Queensland (CARRS-Q), Queensland University of Technology (QUT), Brisbane, Queensland Australia ; Faculty of Health, School of Psychology and Counselling, QUT, Brisbane, Queensland Australia
| | - Alison Mudge
- Internal Medicine and Aged Care, MNHHS, Royal Brisbane and Women's Hospital, Brisbane, Queensland Australia
| | - Alex A Black
- School of Optometry and Vision Science, Institute of Health & Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Mariana Figueiro
- Lighting Research Centre, Rennsselaer Polytechnic Institute, Troy, New York USA
| | - Muhtashimuddin Ahmed
- Safety and Quality Unit, Metro North Hospital and Health Service (MNHHS), Royal Brisbane and Women's Hospital, Brisbane, Queensland Australia
| | - Mark Devitt
- Architectural and Engineering Services, Metro North Hospital and Health Service (MNHHS), Royal Brisbane and Women's Hospital, Brisbane, Queensland Australia
| | - Terry P Haines
- Physiotherapy Department, Monash University, Melbourne, Victoria Australia ; Allied Health Research Unit, Monash Health, Melbourne, Victoria Australia
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Tannenbaum C, van den Heuvel E, Fritel X, Southall K, Jutai J, Rajabali S, Wagg A. Continence Across Continents To Upend Stigma and Dependency (CACTUS-D): study protocol for a cluster randomized controlled trial. Trials 2015; 16:565. [PMID: 26652168 PMCID: PMC4676178 DOI: 10.1186/s13063-015-1099-x] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2015] [Accepted: 12/02/2015] [Indexed: 12/01/2022] Open
Abstract
Background Urinary incontinence occurs in 40 % of women aged 65 years and over; however, only 15 % seek care and many delay healthcare seeking for years. Incontinence is associated with depression, social isolation, reduced quality of life, falls and other comorbidities. It is accompanied by an enormous cost to the individual and society. Despite the substantial implications of urinary incontinence on social, psychological and physical well-being of older women, the impact of continence promotion on urinary symptom improvement and subsequent effects on falls, quality of life, stigma, social participation and the cost of care remains unknown. Methods This study is a mixed methods multi-national open-label 2-arm parallel cluster randomized controlled trial aiming to recruit 1000 community-dwelling incontinent women aged 65 years and older across Quebec, Western Canada, France and United Kingdom. Participants will be recruited through community organizations. Data will be collected at 6 time points: baseline and 1 week, 3 months, 6 months, 9 months and 12 months after baseline. One of the primary objectives is to evaluate whether the continence promotion intervention improves incontinence symptoms (measured with the Patient Global Impression of Improvement questionnaire, PGI-I) at 12 months post intervention compared to the control group. Other co-primary outcomes include changes in incontinence-related stigma, fall reduction, and incremental cost-effectiveness ratio and quality-adjusted life years. Data analysis will account for correlation of outcomes (clustering) within community organizations. A qualitative sub-study will explore stigma reduction. Discussion Community-based continence promotion programs may be a cost-effective strategy to reduce urinary incontinence, stigma and falls among older women with untreated incontinence, and simultaneously improve quality of life and healthy active life expectancy. Trial registration ClinicalTrials.gov: NCT01858493, registered 13 May 2013
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Affiliation(s)
- Cara Tannenbaum
- Institut Universitaire de Gériatrie de Montréal, Faculté de Médecine, Université de Montréal, Montréal, QC, Canada.
| | | | - Xavier Fritel
- Faculty of Medicine and Pharmacy, University of Poitiers, Poitiers, France.
| | - Kenneth Southall
- École d'Orthophonie et d'Audiologie, Université de Montréal, Montréal, QC, Canada.
| | - Jeffrey Jutai
- Interdisciplinary School of Health Sciences, University of Ottawa, Ottawa, ON, Canada.
| | - Saima Rajabali
- Division of Geriatric Medicine, University of Alberta, Edmonton, AB, Canada.
| | - Adrian Wagg
- Division of Geriatric Medicine, University of Alberta, Edmonton, AB, Canada.
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A Preliminary Study on Balance Performance and Fall Status in Older Women With Urinary Incontinence. ACTA ACUST UNITED AC 2015. [DOI: 10.1097/jwh.0000000000000036] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Saccomano SJ, Ferrara LR. Fall prevention in older adults. Nurse Pract 2015; 40:40-48. [PMID: 25922905 DOI: 10.1097/01.npr.0000465117.19783.ee] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Falls in older adults are a major public health concern and can often have fatal results. Practitioners need to be aware of assessment and diagnostic techniques to prevent falls in older adults.
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Affiliation(s)
- Scott J Saccomano
- Scott J. Saccomano is an assistant professor at Herbert H. Lehman College, Department of Nursing, Bronx, N.Y. Lucille R. Ferrara is an associate professor, director Family Nurse Practitioner Program at Pace University, College of Health Professions, Pleasantville, N.Y
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Godmaire GC, Grenier S, Tannenbaum C. An Independent Association Between Urinary Incontinence and Falls in Chronic Benzodiazepine Users. J Am Geriatr Soc 2015; 63:1035-7. [DOI: 10.1111/jgs.13424] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Geneviève Courteau Godmaire
- Faculty of Medicine; Université de Montréal; Institut Universitaire de Gériatrie de Montréal; Montréal QC Canada
| | | | - Cara Tannenbaum
- Faculty of Medicine; Université de Montréal; Institut Universitaire de Gériatrie de Montréal; Montréal QC Canada
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Edwards R, Hunter K, Wagg A. Lower urinary tract symptoms and falls in older women: A case control study. Maturitas 2015; 80:308-11. [DOI: 10.1016/j.maturitas.2014.12.008] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2014] [Revised: 12/14/2014] [Accepted: 12/16/2014] [Indexed: 11/28/2022]
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Roe B, Flanagan L, Maden M. Systematic review of systematic reviews for the management of urinary incontinence and promotion of continence using conservative behavioural approaches in older people in care homes. J Adv Nurs 2015; 71:1464-83. [DOI: 10.1111/jan.12613] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/18/2014] [Indexed: 01/08/2023]
Affiliation(s)
- Brenda Roe
- Evidence-based Practice Research Centre; Faculty of Health & Social Care; Edge Hill University; Ormskirk UK
- Personal Social Services Research Unit; University of Manchester; UK
| | - Lisa Flanagan
- Countess of Chester Hospital NHS Foundation Trust; UK
| | - Michelle Maden
- Faculty of Health & Social Care; Edge Hill University; Ormksirk UK
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