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An D, Wang J, Zhang F, Jing H, Gao Y, Cong H, Su G, Ye M, Hu C, Wu J, Liao L. Effect of Pilates combined with pelvic floor muscle training on continence of post-prostatectomy incontinence in patients with different body mass index. BMC Urol 2024; 24:74. [PMID: 38549067 PMCID: PMC10976754 DOI: 10.1186/s12894-024-01451-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2023] [Accepted: 03/07/2024] [Indexed: 04/01/2024] Open
Abstract
BACKGROUND Urinary incontinence symptoms severely affect older people with different body mass index (BMI).To compare the efficacy of the pelvic floor muscle training (PFMT) in patients with post-prostatectomy incontinence with different BMI. METHODS Thirty-seven patients with post-prostatectomy incontinence were included. They were divided into group A (BMI ≤ 25,12), group B (26 ≤ BMI ≤ 30,14), and group C (BMI ≥ 31,11) based on difference BMI. Three groups of patients underwent the same Pilates combined with kegel training. Participants were assessed with 1-hour pad test, the number of incontinence episodes, International Consultation on Incontinence Questionnaire and Oxford Grading Scale. RESULTS In the 1-hour pad test, the differences before and after training were statistically significant in all three groups of participants. Group A decreased from 81.83 ± 8.79 to 31.08 ± 5.64 g (P < 0.01). Group B decreased from 80.57 ± 8.87 to 35.85 ± 5.66 g (P < 0.01). Group C decreased from 83.55 ± 10.24 to 40.18 ± 7.01 g (P < 0.01). The number of incontinent episodes in group A decreased from 9.33 ± 1.07 to 3.25 ± 0.62 (P < 0.01). Group B decreased from 8.86 ± 1.09 to 3.79 ± 0.80 (P < 0.01). Group C decreased from 9.27 ± 1.10 to 4.09 ± 0.70 (P < 0.01). The correlation between the three groups of participants and the 1-hour pad test, with an R2 of 0.51. The correlation between the three groups of participants and the number of urinary incontinence episodes with a R2 of 0.43. CONCLUSIONS Pelvic floor muscle training can affect the recovery of urinary continence in patients with different BMI. Maintaining a lower BMI can be beneficial for improving urinary control. TRIAL REGISTRATION Date of trial registration: November 27, 2023.
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Affiliation(s)
- Di An
- Department of physiotherapy 2 (PT2), China Rehabilitation Research Center the School of Rehabilitation, Capital Medical University, NO 10, Jiaomen Beilu, Fengtai district, Beijing, 100068, China
| | - Jianxia Wang
- Department of Intensive Care Unit, Cancer Hospital Chinese Academy of Medical Science, National Cancer Center/ National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Chaoyang District, Beijing, China
| | - Fan Zhang
- Department of Urology, China Rehabilitation Research Center, Fengtai district, Beijing, China
| | - Huafang Jing
- Department of Urology, China Rehabilitation Research Center, Fengtai district, Beijing, China
| | - Yi Gao
- Department of Urology, China Rehabilitation Research Center, Fengtai district, Beijing, China
| | - Huiling Cong
- Department of Urology, China Rehabilitation Research Center, Fengtai district, Beijing, China
| | - Guodong Su
- Department of physiotherapy 3(PT3), China Rehabilitation Research Center, Fengtai district, Beijing, China
| | - Miao Ye
- Department of physiotherapy 2 (PT2), China Rehabilitation Research Center the School of Rehabilitation, Capital Medical University, NO 10, Jiaomen Beilu, Fengtai district, Beijing, 100068, China
| | - Chunying Hu
- Department of physiotherapy 2 (PT2), China Rehabilitation Research Center the School of Rehabilitation, Capital Medical University, NO 10, Jiaomen Beilu, Fengtai district, Beijing, 100068, China
| | - Juan Wu
- Department of Urology, China Rehabilitation Research Center, Fengtai district, Beijing, China
| | - Limin Liao
- China Rehabilitation Research Center (CRRC), Department of Urology of Beijing Boai Hospital, Department of Urology of Capital Medical University, NO 10, Jiaomen Beilu, Beijing, 100068, China.
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Özden F, Özkeskin M, Tümtürk İ, Yalçın M. The investigation of cognition, proprioception, sensory and physical function in stroke patients with urinary incontinence. Int Urol Nephrol 2023:10.1007/s11255-023-03647-5. [PMID: 37253930 DOI: 10.1007/s11255-023-03647-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2023] [Accepted: 05/23/2023] [Indexed: 06/01/2023]
Abstract
PURPOSE This study aimed to investigate cognition, proprioception, and sensory/physical function in stroke patients with urinary incontinence (UI). METHODS A prospective cross-sectional study was conducted on 53 individuals with stroke (23 had UI and 21 matched controls). The Incontinence Impact Questionnaire Short Form (IIQ-7) and Urogenital Distress Inventory (UDI-6) were used to assess the patients' UI symptoms. Participants were also evaluated with Mini-Mental State Examination (MMSE), Barthel Index (BI), Fugl-Meyer Sensory Assessment (FMA-S), Five Times Sit to Stand Test (FTSST), Functional Reach Test (FRT) and Proprioception Test. RESULTS FTSST, FRT and FMA-S were better in stroke subjects without UI (p < 0.05). There was a moderate correlation between IIQ-7 with FMA-S, FTSST and proprioception (left extremity) (r1: - 0.415, r2: 0.440, r3: 0.430, p < 0.05) and a low correlation with BI (r: - 0.356, p < 0.05). CONCLUSION Individuals with UI had worse sensory/motor function and static balance. Stroke patients with UI were more dependent, had less sensory function, and had worse lower extremity muscle strength and proprioception as the level of urinary incontinence increased. To reduce urinary incontinence, emphasis on motor/sensory function, balance, and proprioception should be considered.
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Affiliation(s)
- Fatih Özden
- Köyceğiz Vocational School of Health Services, Department of Health Care Services, Muğla Sıtkı Koçman University, Köyceğiz, 48800, Muğla, Turkey.
| | - Mehmet Özkeskin
- Faculty of Health Sciences, Department of Physiotherapy and Rehabilitation, Ege University, İzmir, Turkey
| | - İsmet Tümtürk
- Institute of Health Sciences, Department of Physiotherapy and Rehabilitation, Süleyman Demirel University, Isparta, Turkey
| | - Mustafa Yalçın
- Department of Physiotherapy and Rehabilitation, Bursa Çekirge State Hospital, Bursa, Turkey
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Barbagallo M, Smith L, Koyanagi A, Dominguez LJ, Fazzari A, Marrone E, Maggi S, Ruotolo G, Castagna A, Veronese N. Multimorbidity increased the risk of urinary incontinence in community-dwelling adults: Results from the English Longitudinal Study On Ageing. Maturitas 2023; 169:40-45. [PMID: 36669309 DOI: 10.1016/j.maturitas.2022.12.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2022] [Revised: 09/05/2022] [Accepted: 12/20/2022] [Indexed: 01/15/2023]
Abstract
Multimorbidity (MM) is common in older people. Recent evidence, largely from cross-sectional studies, suggests that MM could be a risk factor for urinary incontinence (UI). For this reason, we aimed to explore the association between MM at baseline and incident UI, and which individual chronic medical conditions/factors might explain the association between MM and UI, using data from the English Longitudinal Study on Ageing, during ten years of follow-up. MM was defined as having two or more chronic medical conditions; the presence of UI was assessed using self-reported information. A logistic regression analysis, adjusted for baseline potential confounders, was used to assess the association between MM and UI, reporting the data as odds ratios (ORs) with their 95 % confidence intervals (CIs). Of 9432 initial participants, 6742 (mean age: 64.8 years; 53.2 % females) without UI at baseline were included in the analysis. MM was present at baseline in 48.8 % of the participants. People with MM had a significantly higher cumulative incidence of UI than their counterparts, leading to a significantly higher risk of UI also after adjusting for potential confounders at baseline (OR = 1.30; 95 % CI: 1.14-1.48). Among the medical conditions, only three were significantly associated with incident UI, namely asthma, Parkinson's disease, and psychiatric disorders. In conclusion, MM at baseline was associated with an increased risk of UI during ten years of follow-up, suggesting that UI is more likely to be present in people with several chronic medical conditions.
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Affiliation(s)
- Mario Barbagallo
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Lee Smith
- 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
| | - Ligia J Dominguez
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy; Faculty of Medicine and Surgery, Kore University of Enna, 94100 Enna, Italy
| | - Anna Fazzari
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Eliana Marrone
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy
| | - Stefania Maggi
- National Research Council, Neuroscience Institute, Padua, Italy
| | | | | | - Nicola Veronese
- Geriatric Unit, Department of Internal Medicine and Geriatrics, University of Palermo, Palermo, Italy.
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Smith L, Shin JI, Ghayda RA, Hijaz A, Sheyn D, Pope R, Hong SH, Kim SE, Ilie PC, Carrie AM, Ippoliti S, Soysal P, Barnett Y, Pizzol D, Koyanagi A. Physical multimorbidity and incident urinary incontinence among community-dwelling adults aged ≥50 years: findings from a prospective analysis of the Irish Longitudinal Study on Ageing. Age Ageing 2021; 50:2038-2046. [PMID: 34279551 DOI: 10.1093/ageing/afab151] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND There are no prospective studies on the association between multimorbidity and urinary incontinence (UI), while mediators in this association are unknown. Thus, we aimed to (i) investigate the longitudinal association between multimorbidity and UI in a large sample of Irish adults aged ≥50 years and (ii) investigate to what extent physical activity, polypharmacy, cognitive function, sleep problems, handgrip strength and disability mediate the association. METHODS Data on 5,946 adults aged ≥50 years old from the Irish Longitudinal Study on Aging were analysed. The baseline survey was conducted between 2009 and 2011 and follow-up after 2 years was conducted. Information on self-reported occurrence of UI in the past 12 months and lifetime diagnosis of 14 chronic conditions were obtained. Multivariable logistic regression and mediation analysis were conducted. RESULTS After adjustment for potential confounders, compared to having no chronic conditions at baseline, having three (odds ratio [OR] = 1.79; 95% confidence interval [CI] = 1.30-2.48) and four or more (OR = 1.86; 95% CI = 1.32-2.60), chronic conditions were significantly associated with incident UI. Mediation analysis showed that polypharmacy, sleep problems and disability explained 22.7, 17.8 and 14.7% of the association between multimorbidity (i.e. two or more chronic conditions) and incident UI, respectively. CONCLUSION A greater number of chronic conditions at baseline were associated with a higher risk for incident UI at 2-year follow-up among adults aged ≥50 years in Ireland. Considering the effects of different medications on UI and improving sleep quality and disability among people aged ≥50 years with multimorbidity may reduce the incidence of UI.
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Affiliation(s)
- Lee Smith
- The Cambridge Centre for Sport and Exercise Sciences, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Jae Il Shin
- Department of Pediatrics, Yonsei University College of Medicine, Seoul, Republic of Korea
| | - Ramy Abou Ghayda
- Urology Institute, University Hospital System, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Adonis Hijaz
- Urology Institute, University Hospital System, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - David Sheyn
- Urology Institute, University Hospital System, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Rachel Pope
- Urology Institute, University Hospital System, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Sun Hwi Hong
- Department of Global Health and Population, Harvard TH Chan School of Public Health, Boston, MA, USA
| | - Sung Eun Kim
- Yonsei University College of Medicine, Seoul, Republic of Korea
- Department of Biotechnology, College of Life Science and Biotechnology, Yonsei University, Seoul, Republic of Korea
| | - Petre Cristian Ilie
- Queen Elizabeth Hospital King’s Lynn Foundation Trust, King’s Lynn PE30 4ET, UK
| | - Anne Marie Carrie
- Queen Elizabeth Hospital King’s Lynn Foundation Trust, King’s Lynn PE30 4ET, UK
| | - Simona Ippoliti
- Queen Elizabeth Hospital King’s Lynn Foundation Trust, King’s Lynn PE30 4ET, UK
| | - Pinar Soysal
- Department of Geriatric Medicine, Faculty of Medicine, Bezmialem Vakif University, Istanbul, Turkey
| | - Yvonne Barnett
- Faculty of Science and Engineering, Anglia Ruskin University, Cambridge CB1 1PT, UK
| | - Damiano Pizzol
- Italian Agency for Development Cooperation, Khartoum, Sudan
| | - Ai Koyanagi
- Research and Development Unit, Parc Sanitari Sant Joan de Déu, CIBERSAM, 08830 Barcelona, Spain
- ICREA, 08010 Barcelona, Spain
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Kayser SA, Koloms K, Murray A, Khawar W, Gray M. Incontinence and Incontinence-Associated Dermatitis in Acute Care: A Retrospective Analysis of Total Cost of Care and Patient Outcomes From the Premier Healthcare Database. J Wound Ostomy Continence Nurs 2021; 48:545-552. [PMID: 34781311 PMCID: PMC8601665 DOI: 10.1097/won.0000000000000818] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
PURPOSE To evaluate the prevalence of incontinence and treatment of incontinence-associated dermatitis (IAD) and associations with outcomes including total cost of care, length of stay (LOS), 30-day readmission, sacral area pressure injuries present on admission and hospital acquired pressure injuries, and progression of all sacral area pressure injuries to a higher stage. DESIGN Retrospective analysis. SUBJECTS AND SETTINGS Data were retrieved from the Premier Healthcare Database and comprised more than 15 million unique adult patient admissions from 937 hospitals. Patients were 18 years or older and admitted to a participating hospital between January 1, 2016, and December 31, 2019. METHODS Given the absence of an IAD International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM) code, we categorized patients treated for IAD by selecting patients with a documented incontinence ICD-10-CM code and a documented charge for dermatology products used to treat IAD. The t test and χ2 tests determined whether incontinence and treatment for IAD were associated with outcomes. RESULTS Incontinence prevalence was 1.5% for the entire sample; prevalence rate for IAD among incontinent patients was 0.7%. As compared to continent patients, incontinent patients had longer LOS (6.4 days versus 4.4 days), were 1.4 times more likely to be readmitted, 4.7 times more likely to have a sacral pressure injury upon admission pressure injury, 5.1 times more likely to have a sacral hospital-acquired pressure injury, and 5.8 times more likely to have a sacral pressure injury progress to a severe stage. As compared to incontinent patients without IAD treatment, those with IAD treatment had longer LOS (9.7 days versus 6.4 days), were 1.3 times more likely to be readmitted, and were 2.0 times more likely to have a sacral hospital-acquired pressure injury. Total index hospital costs were 1.2 times higher for incontinent patients and 1.3 times higher for patients with IAD treatment. CONCLUSIONS Incontinence and IAD prevalence are substantially lower than past research due to underreporting of incontinence. The lack of an ICD-10-CM code for IAD further exacerbates the underreporting of IAD. Despite low prevalence numbers, our results show higher health care costs and worse outcomes for incontinent patients and patients with IAD treatment.
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Affiliation(s)
- Susan A. Kayser
- Susan A. Kayser, PhD, Hillrom Holdings, Inc, Batesville, Indiana
- Kimberly Koloms, MS, Hillrom Holdings, Inc, Chicago, Illinois
- Angela Murray, MN, RN, Hillrom Holdings, Inc, Chicago, Illinois
- Waqaar Khawar, MD, Hillrom Holdings, Inc, Chicago, Illinois
- Mikel Gray, PhD, Department of Urology, University of Virginia Charlottesville
| | - Kimberly Koloms
- Susan A. Kayser, PhD, Hillrom Holdings, Inc, Batesville, Indiana
- Kimberly Koloms, MS, Hillrom Holdings, Inc, Chicago, Illinois
- Angela Murray, MN, RN, Hillrom Holdings, Inc, Chicago, Illinois
- Waqaar Khawar, MD, Hillrom Holdings, Inc, Chicago, Illinois
- Mikel Gray, PhD, Department of Urology, University of Virginia Charlottesville
| | - Angela Murray
- Susan A. Kayser, PhD, Hillrom Holdings, Inc, Batesville, Indiana
- Kimberly Koloms, MS, Hillrom Holdings, Inc, Chicago, Illinois
- Angela Murray, MN, RN, Hillrom Holdings, Inc, Chicago, Illinois
- Waqaar Khawar, MD, Hillrom Holdings, Inc, Chicago, Illinois
- Mikel Gray, PhD, Department of Urology, University of Virginia Charlottesville
| | - Waqaar Khawar
- Susan A. Kayser, PhD, Hillrom Holdings, Inc, Batesville, Indiana
- Kimberly Koloms, MS, Hillrom Holdings, Inc, Chicago, Illinois
- Angela Murray, MN, RN, Hillrom Holdings, Inc, Chicago, Illinois
- Waqaar Khawar, MD, Hillrom Holdings, Inc, Chicago, Illinois
- Mikel Gray, PhD, Department of Urology, University of Virginia Charlottesville
| | - Mikel Gray
- Susan A. Kayser, PhD, Hillrom Holdings, Inc, Batesville, Indiana
- Kimberly Koloms, MS, Hillrom Holdings, Inc, Chicago, Illinois
- Angela Murray, MN, RN, Hillrom Holdings, Inc, Chicago, Illinois
- Waqaar Khawar, MD, Hillrom Holdings, Inc, Chicago, Illinois
- Mikel Gray, PhD, Department of Urology, University of Virginia Charlottesville
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Kańtoch A, Grodzicki T, Wójkowska-Mach J, Heczko P, Gryglewska B. Explanatory survival model for nursing home residents- a 9-year retrospective cohort study. Arch Gerontol Geriatr 2021; 97:104497. [PMID: 34411924 DOI: 10.1016/j.archger.2021.104497] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Revised: 07/22/2021] [Accepted: 07/24/2021] [Indexed: 02/07/2023]
Abstract
PURPOSE There is a gap in the literature regarding the analysis of long-term survival and mortality risk factors among disabled and multimorbid institutionalized populations. The study aimed to analyze 9-year survival, investigate mortality factors, and develop an explanatory survival model for nursing home residents. MATERIALS AND METHODS A retrospective cohort study with a 9-year follow-up (2009-2018) was conducted among 96 residents of a nursing home with Barthel index ≤ 40. The study was based on baseline measurements performed in 2009, which included results obtained on geriatric scales: Mini Nutritional Assessment Short-Form (MNA-SF) and Abbreviated Mental Test Score (AMTS). Information on demographics, comorbidities, pharmacotherapy, transfers and deaths came from medical records. Kaplan-Meier curves were used to estimate and present survival data. Factors associated with mortality were determined using Cox proportional hazard models. RESULTS The median survival was 2.9 years. Mortality during the follow-up period was 83%. Kaplan-Meier curves showed that residents with normal nutritional status (p = 0.002) and taking aspirin (p = 0.005) had a better 9-year survival. The multivariable Cox regression model revealed that the risk of mortality (Hazard Ratio, HR) increased in older age (HR=1.04), male gender (HR=2.08), with risk of malnutrition (HR=3.91), malnutrition (HR=4.84), and presence of urinary incontinence (HR=2.14). The aspirin use was the strongest protective factor against death (HR=0.40). CONCLUSION The aspirin use was associated with better long-term survival for nursing home residents. Factors associated with higher mortality among residents include older age, male gender, poor nutritional status, and urinary incontinence. BRIEF SUMMARY We are the first to report the beneficial effects of a low-dose of aspirin on the long-term survival of disabled, institutionalized populations with multimorbidity. Furthermore, this study presents an explanatory model of survival for nursing home residents and identifies the long-term mortality risk factors among disabled residents with multimorbidity.
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Affiliation(s)
- Anna Kańtoch
- Jagiellonian University Medical College, Faculty of Medicine, Department of Internal Medicine and Gerontology, University Hospital in Kraków, 2 Jakubowskiego Str., Building I, 30-688 Kraków, Poland
| | - Tomasz Grodzicki
- Jagiellonian University Medical College, Faculty of Medicine, Department of Internal Medicine and Gerontology, University Hospital in Kraków, 2 Jakubowskiego Str., Building I, 30-688 Kraków, Poland
| | - Jadwiga Wójkowska-Mach
- Jagiellonian University Medical College, Faculty of Medicine, Department of Microbiology, 18 Czysta Str., 31-121 Kraków, Poland
| | - Piotr Heczko
- Jagiellonian University Medical College, Faculty of Medicine, Department of Microbiology, 18 Czysta Str., 31-121 Kraków, Poland
| | - Barbara Gryglewska
- Jagiellonian University Medical College, Faculty of Medicine, Department of Internal Medicine and Gerontology, University Hospital in Kraków, 2 Jakubowskiego Str., Building I, 30-688 Kraków, Poland.
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Huang P, Luo K, Wang C, Guo D, Wang S, Jiang Y, Huang W, Zhang W, Ding M, Wang J. Urinary Incontinence Is Associated With Increased All-Cause Mortality in Older Nursing Home Residents: A Meta-Analysis. J Nurs Scholarsh 2021; 53:561-567. [PMID: 34021695 DOI: 10.1111/jnu.12671] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2021] [Indexed: 01/11/2023]
Abstract
PURPOSE Urinary incontinence is a syndrome common in older adults, but it is not clear whether urinary incontinence is associated with the risk for mortality in elderly nursing home residents. METHODS We conducted a systematic review and meta-analysis in PubMed, Cochrane, Embase, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and Web of Science databases. The Newcastle-Ottawa Scale (NOS) was used to assess the quality of the included studies. The meta-analysis was summarized using a random-effects or fixed-effects model, and the heterogeneity among studies was examined using the I2 statistic. FINDINGS Six cohort studies with 1,656 participants were included in the final analysis. The NOS score for each study was greater than 6. Urinary incontinence was significantly associated with a higher risk for mortality in nursing homes, with a hazard ratio (HR) of 1.20 (95% confidence interval [CI] 1.12-1.28, I2 = 41.6%). The significant association of urinary incontinence with increased mortality risk was observed in subgroup analysis according to region, status of dementia, and follow-up period, with a pooled HR of 2.02 (95% CI 1.32-3.11, I2 = 0%) for Asian countries, 1.18 (95% CI 1.11-1.26, I2 = 41.6%) for Western countries, 1.17 (95% CI 1.09-1.26, I2 = 0%) for patients with dementia, 1.35 (95% CI 1.13-1.60, I2 = 58.9%) for patients without dementia, 1.16 (95% CI 1.07-1.25, I2 = 43.2%) for studies with a follow-up period of 1 year, and 1.30 (95% CI 1.15-1.48, I2 = 24.5%) for studies with a follow-up period of more than 1 year. CONCLUSIONS Urinary incontinence is associated with an increased risk for death among residents of care facilities. Therefore, it was necessary to screen the elderly dwelling in nursing homes who were experiencing or at risk for urinary incontinence with useful tools (e.g., overactive bladder symptom score, bladder control self-assessment questionnaire, three incontinence questions). In addition, early interventions strategies, such as weight loss, stopping smoking, pelvic floor muscle training, and medical and surgical treatments would contribute to decreasing the risk for urinary incontinence and preventing adverse outcomes in nursing home residents. CLINICAL RELEVANCE In our study, we found that the elderly with urinary incontinence who resided in nursing homes had a higher risk for mortality than those without urinary incontinence. Therefore, urinary incontinence in the elderly residing in nursing homes is of particular concern. Early detection and intervention are important for the elderly with urinary incontinence, and caregivers should be made aware of this importance.
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Affiliation(s)
- Pan Huang
- Lecturer, College of Nursing, Wenzhou Medical University, Wenzhou, Zhejiang Province, China
| | - Kai Luo
- Medical student, Department of Medicine, JingGangshan University, Ji'an, Jiangxi Province, China
| | - Chunyan Wang
- Medical student, Department of Medicine, JingGangshan University, Ji'an, Jiangxi Province, China
| | - Dawei Guo
- Medical student, Department of Medicine, JingGangshan University, Ji'an, Jiangxi Province, China
| | - Shixuan Wang
- Medical student, Department of Medicine, JingGangshan University, Ji'an, Jiangxi Province, China
| | - Yuan Jiang
- Medical student, Department of Medicine, JingGangshan University, Ji'an, Jiangxi Province, China
| | - Wenxuan Huang
- Medical student, Ji'an Social Organization Cultivation and Development Center, Ji'an, Jiangxi Province, China
| | - Weiqiangxin Zhang
- Medical student, Department of Medicine, JingGangshan University, Ji'an, Jiangxi Province, China
| | - Mei Ding
- Medical student, Department of Medicine, JingGangshan University, Ji'an, Jiangxi Province, China
| | - Jiang Wang
- Lecturer, College of Nursing, JingGangshan Univeristy, Ji'an, Jiangxi, 343009, China.,Lecturer, Department of Medicine, JingGangshan University, Ji'an, 343009, China
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Sullivan R, McNicholas T, Claffey P, Kenny RA, Briggs R. Unreported urinary incontinence: population-based prevalence and factors associated with non-reporting of symptoms in community-dwelling people ≥ 50 years. Eur Geriatr Med 2020; 12:405-412. [PMID: 33029753 DOI: 10.1007/s41999-020-00412-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/24/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE Concerns exist around under-detection and under-treatment of urinary incontinence (UI) in specific patient groups, particularly older people. The aim of this study is to ascertain the prevalence of unreported UI in a large sample of older adults, to profile factors associated with under-reporting of UI and the association of unreported UI with quality of life (QOL). METHODS This study was embedded within the Irish Longitudinal Study on Ageing, involving a population-representative sample of almost 7,000 older adults (55% female, mean age 65 years). UI was defined as involuntary loss of urine from the bladder occurring on average at least twice per month. Unreported UI had not yet been reported to a healthcare professional. QOL was measured using the Control, Autonomy, Self-realisation and Pleasure-19 Scale (CASP-19). RESULTS Almost 40% (285/750) of participants with UI had not reported symptoms to a healthcare professional despite visiting their general practitioner (GP) on average over 4 times in the last year. Logistic regression modelling demonstrated that under-reporting of UI was associated with female sex, taking < 5 medications, less severe symptoms and lower number of GP visits. Linear regression models show that unreported UI was associated with significantly lower CASP-19 (β = - 1.20 (95% CI: - 2.19 to - 0.20)). CONCLUSION Only 40% of older people with UI report symptoms to a healthcare professional despite frequent symptoms, and a significant association with poorer QOL. This highlights the need to educate older people around seeking help for UI, as well as opportunistically addressing UI as part of comprehensive age-attuned care.
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Affiliation(s)
- Rachel Sullivan
- Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland
| | - Triona McNicholas
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
- Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland
| | - Paul Claffey
- Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
- Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland
- Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
| | - Robert Briggs
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland.
- Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland.
- Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland.
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Suzuki M, Okochi J, Iijima K, Murata T, Kume H. Nationwide survey of continence status among older adult residents living in long-term care facilities in Japan: The prevalence and associated risk factors of incontinence and effect of comprehensive care on continence status. Geriatr Gerontol Int 2020; 20:285-290. [PMID: 31991532 DOI: 10.1111/ggi.13872] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Revised: 12/22/2019] [Accepted: 01/04/2020] [Indexed: 12/15/2022]
Abstract
AIM This study aimed to identify the prevalence of urinary, fecal and double incontinence among Japanese residents aged ≥65 years living in long-term care facilities. Furthermore, the association between baseline characteristics and changes in toileting activity after a 3-month comprehensive care among older individuals was investigated. METHODS We examined the prevalence of incontinence and its significant predictors. The association between the Functional Independence Measure score at baseline and each type of incontinence (urinary, fecal or double incontinence) was examined using a logistic regression model. Similarly, the association between the Functional Independence Measure score at baseline and improvement in toileting activity after a 3-month comprehensive care was examined. RESULTS In total, 2517 residents (670 men and 1847 women) were recruited. The prevalence rates of urinary, fecal and double incontinence were 66.9%, 42.8% and 41.1%, respectively. In multivariate analysis, the sum of the motor subscales after removing four continence items and the sum of the cognitive subscales of the Functional Independence Measure score at baseline were significantly associated with all types of incontinence. The sum of the motor subscales after removing four continence items of the Functional Independence Measure score was associated with improved toileting activity. CONCLUSIONS This study presented the prevalence of urinary, fecal and double incontinence among residents living in long-term care facilities in Japan. The Functional Independence Measure items at baseline were associated with not only continence status, but also improved toileting activity after 3-month comprehensive care. Geriatr Gerontol Int 2020; 20: 285-290.
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Affiliation(s)
- Motofumi Suzuki
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan.,Department of Urology, Tokyo Teishin Hospital, Tokyo, Japan
| | - Jiro Okochi
- Tatsumanosato Long-Term Care Health Facility, Osaka, Japan
| | - Katsuya Iijima
- Institute of Gerontology, The University of Tokyo, Tokyo, Japan
| | - Taro Murata
- Department of Urology, Tokyo Teishin Hospital, Tokyo, Japan
| | - Haruki Kume
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Tokyo, Japan
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Nazzal Z, Khatib B, Al-Quqa B, Abu-Taha L, Jaradat A. The prevalence and risk factors of urinary incontinence amongst Palestinian women with type 2 diabetes mellitus: A cross-sectional study. Arab J Urol 2019; 18:34-40. [PMID: 32082632 PMCID: PMC7006689 DOI: 10.1080/2090598x.2019.1699340] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2019] [Accepted: 11/17/2019] [Indexed: 11/30/2022] Open
Abstract
Objective: To determine the prevalence of urinary incontinence (UI) in women with type 2 diabetes mellitus (T2DM) in the North West Bank, Palestine, and to assess the role of potential risk factors including age and DM control. Patients and methods: Adult women with DM attending governmental primary healthcare centres in the North West Bank were interviewed using the Centers for Disease Control and Prevention National Health and Nutrition Examination Survey (NHANES) standardised UI questionnaire. The prevalence of UI was estimated and differences between groups were evaluated using the chi-square test. A multivariate logistic model was used to estimate the adjusted relationships and to control for confounders. The statistical significance level was set at P < 0.05. The study was approved by the Institutional Review Board at An-Najah National University. Results: The study included 381 women with T2DM, aged 30–83 years, of whom 43.2% (95% confidence interval [CI] = 37.9–47.8%) reported UI regardless of the type. About 40% reported that they were extremely bothered by the condition and 35.2% stated that their daily routine life was greatly affected. Amongst the women with UI, 133 (80.6%) and 128 (77.6%) were found to have urge and stress UI, respectively. UI was found to be significantly associated with a history of recurrent urinary tract infection (adjusted odds ratio [OR] 3.0, 95% CI 1.9–4.9; P < 0.001) and parity (adjusted OR 1.7, 95% CI 1.1–2.7; P = 0.04) Conclusions: The prevalence of UI amongst Palestinian women with T2DM regardless of the type is high. The findings highlight the importance of educating women with T2DM about UI. The medical team should focus on this problem as it is often neglected; physicians should be alert for UI as it is often underreported and therefore undertreated. Abbreviations: BMI: body mass index; (T2)DM: (type 2) diabetes mellitus; HbA1c: haemoglobin A1c; MoH: Ministry of Health; NHANES: National Health and Nutrition Examination Survey; OR: odds ratio; QoL: quality of life; (S)(U)UI: (stress) (urge) urinary incontinence.
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Affiliation(s)
- Zaher Nazzal
- Department of Family and Community Medicine, Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Batool Khatib
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Bayan Al-Quqa
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Lina Abu-Taha
- Faculty of Medicine and Health Sciences, An-Najah National University, Nablus, Palestine
| | - Ahmad Jaradat
- Department of Urology, An-Najah National University Hospital, Nablus, Palestine
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11
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Aging in Place: Implications for Continence Care for Older People. Eur Urol 2019; 75:272-273. [DOI: 10.1016/j.eururo.2018.11.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2018] [Accepted: 11/08/2018] [Indexed: 11/23/2022]
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Cubukcu M. The Impact of Urinary Incontinence on Quality of Life in Those Receiving Home Care Services. HOME HEALTH CARE MANAGEMENT AND PRACTICE 2019. [DOI: 10.1177/1084822318795439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This study aims to evaluate the impact of urinary incontinence on the quality of life in those receiving home care services and the factors that influence this. This cross-descriptive study was performed in 180 patients who were served from Home Care Services between 01 and 28 February 2018. An International Consultation on Incontinence Questionnaire–Short Form (ICIQ-SF) was implemented in person to those who gave their informed consent with orientation and cooperation. The mean age of a 180 patients was 74.40 ± 7.80 years (min = 18, max = 104), of which 55.2% were women. The mean ICIQ-SF score was found to be 12.42 ± 4.83 (min = 0, max = 21). The lowest points were given as responses to the question, “In your opinion, what amount of leakage do you experience?” The highest points, however, were given to the question of “How much does urinary leakage interfere with your everyday life?” It was seen that when quality of life is assessed with a visual analog scale within the ICIQ-SF, the quality of life for 66.6% of elderly individuals was affected moderately or significantly. The mean ICIQ-SF scores were higher in those with chronic diseases ( p < .005). Urinary Incontinence negatively affects quality of life to a moderate and significant degree in those receiving home care. The quality of life for those who have chronic diseases was worse. In this respect, there is a need to support patients in those receiving home care services.
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Affiliation(s)
- Mahcube Cubukcu
- Health Sciences University Samsun Education and Research Hospital, Turkey
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13
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Suzuki M, Miyazaki H, Kamei J, Yoshida M, Taniguchi T, Nishimura K, Igawa Y, Sanada H, Homma Y. Ultrasound-assisted prompted voiding care for managing urinary incontinence in nursing homes: A randomized clinical trial. Neurourol Urodyn 2019; 38:757-763. [PMID: 30620134 PMCID: PMC6849834 DOI: 10.1002/nau.23913] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Accepted: 11/21/2018] [Indexed: 01/09/2023]
Abstract
Aims To determine whether ultrasound‐assisted prompted voiding (USAPV) care is more efficacious than conventional prompted voiding (CPV) care for managing urinary incontinence in nursing homes. Methods Thirteen participating nursing homes in Japan were randomized to CPV (n = 7) or USAPV care group (n = 6). Residents of the allocated nursing homes received CPV (n = 35) or USAPV (n = 45) care for 8 weeks. In the CPV group, caregivers asked the elderly every 2‐3 h whether they had a desire to void and prompted them to void when the response was yes. In the USAPV group, caregivers regularly monitored bladder urine volume by an ultrasound device and prompted them to void when the volume reached close to the individually optimized bladder capacity. Frequency‐volume chart was recorded at the baseline and after the 8‐week intervention to measure the daytime urine loss. Results The change in daytime urine loss was statistically greater in the USAPV (median, −80.0 g) than in the CPV (median, −9.0 g; P = .018) group. The proportion of elderly individuals whose daytime urine loss decreased by >25% was 51% and 26% in the USAPV and CPV group, respectively (P = .020). Quality‐of‐life measures of elderly participants showed no significant changes in both groups. The care burden scale score of caregivers was unchanged in the USAPV group (P = .59) but significantly worsened in the CPV group (P = .010) after the intervention. Conclusions USAPV is efficacious and feasible for managing urinary incontinence in nursing homes.
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Affiliation(s)
- Motofumi Suzuki
- Department of Urology, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hideyo Miyazaki
- Department of Urology, Center Hospital of the National Center for Global Health and Medicine, Shinjuku-ku, Tokyo, Japan
| | - Jun Kamei
- Department of Urology, Graduate School of Medicine, Jichi Medical University, Shimotsuke-city, Tochigi, Japan
| | - Mikako Yoshida
- Department of Imaging Nursing Science, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Tamami Taniguchi
- Graduate Faculty of Medicine, Department of Health and Life Support Nursing Science, University of Yamanashi, Chuo-city, Yamanashi, Japan
| | | | - Yasuhiko Igawa
- Department of Continence Medicine, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Hiromi Sanada
- Department of Gerontological Nursing/Wound Care Management, Graduate School of Medicine, The University of Tokyo, Bunkyo-ku, Tokyo, Japan
| | - Yukio Homma
- Japanese Red Cross Medical Center, Shibuya-ku, Tokyo, Japan
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14
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Amancio TG, Oliveira MLCD, Amancio VDS. Factors influencing the condition of vulnerability among the elderly. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2019. [DOI: 10.1590/1981-22562019022.180159] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Abstract Objective: Describe health conditions and life habits using Vulnerable Elders Survey-13 scores, with the aim of understanding the factors associated with the vulnerability of the elderly. Method: A quantitative, cross-sectional study was conducted in the Distrito Federal, Brazil. Data were collected by a questionnaire containing the Vulnerable Elders Survey-13 and other variables. Descriptive statistics, correlation and regression analyses were carried out. Results: 956 people aged 60 years and older living in the Distrito Federal were interviewed. Of these, 32.4% had scores equal to or greater than three, and were therefore classified as vulnerable. Some variables exhibited a positive relation with VES-13 score, with intensity ranging from very weak, in the case of systemic arterial hypertension (p=0.035) and diabetes mellitus (p=0.027), to moderate, as was the case with depression (p<0.001), urinary loss (p<0.001) and falls (p<0.001). It was also observed that a 1% increase in the income of the elderly resulted in a reduction of 0.27 points (p<0,001) in Vulnerable Elders Survey score, reducing vulnerability. Conclusion: Depression most influenced vulnerability score, followed by urinary and hearing loss. Public policies aimed at the promotion of the physical and mental health of the elderly and the creation of a propitious environment to increase income, through reinsertion into the labor market or welfare policies, can help to reduce vulnerability.
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15
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Yoo R, Spencer M. Continence Promotion and Successful Aging: The Role of the Multidisciplinary Continence Clinic. Geriatrics (Basel) 2018; 3:geriatrics3040091. [PMID: 31011126 PMCID: PMC6371153 DOI: 10.3390/geriatrics3040091] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2018] [Revised: 12/14/2018] [Accepted: 12/15/2018] [Indexed: 11/16/2022] Open
Abstract
Incontinence is a common yet under-recognized issue that impacts quality of life, especially for older adults in whom there is often a multifactorial etiology. A retrospective chart review was performed on a representative sample of patients seen at our multidisciplinary continence clinic in Vancouver, Canada from January to December 2017 inclusive. Initial assessment was performed by the nurse continence advisor (NCA) or geriatrician depending on the source of referral. The pelvic floor physiotherapist (PFP) could then be consulted based on perceived need. The average age at assessment was 76 years old (range 29⁻102), with 82% of patients ≥65 years and 27% ≥85 years old. The majority of patients were referred for bladder incontinence (72%), with the remaining patients referred for bowel incontinence (28%) or pessary care (7%). Referrals came from a variety of sources including physicians (62%), nurses (22%), allied health care providers (12%) and self-referral (5%). Multimorbidity was common, with 40% of patients having a Charlson Comorbidity Index ≥6. The same proportion of patients (40%) were on ≥5 prescription medications. Many patients were functionally dependent for either instrumental activities of daily living (52%) or activities of daily living (25%). Non-pharmacologic treatments were commonly recommended, with the majority of patients counselled on lifestyle changes (88%) and taught Kegel exercises (70%). For patients seen by the geriatrician, modifications were made to non-continence medications in 50% of cases and medical comorbidities were optimized in 39% of cases. In terms of pharmacologic therapy, over-the-counter (OTC) medications were initiated in 45% of patients whereas continence-specific prescription medications were started in 17% of patients. A multidisciplinary continence clinic can play an important role in promoting successful aging by assessing and treating medical causes of incontinence in medically complex older adults.
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Affiliation(s)
- Rhena Yoo
- MD Program, Faculty of Medicine, University of British Columbia, Vancouver, BC, V6T 1Z3, Canada.
| | - Martha Spencer
- Division of Geriatric Medicine, Providence Health Care, Vancouver, BC, V6Z 1Y6, Canada.
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Screening for urinary incontinence in acute care for elders unit: comparative performance analysis of Katz's ADL and ICIQ-UI-SF. Eur Geriatr Med 2018; 9:579-588. [PMID: 34654229 DOI: 10.1007/s41999-018-0090-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2018] [Accepted: 07/31/2018] [Indexed: 10/28/2022]
Abstract
BACKGROUND Urinary incontinence (UI) is a frequent, but neglected geriatric syndrome, particularly in vulnerable older patients. Optimizing screening procedures is necessary. OBJECTIVE To compare the clinometric performances of the "continence" item of the Katz's ADL scale and the ICIQ-UI-sf for the screening of UI in vulnerable aged patients. METHODS A prospective study was conducted in the acute care for elders (ACE) unit of an academic centre. Two independent nurses screened all patients with spontaneous urination for UI with Katz's ADL item and ICIQ-UI-sf upon the hospital admission. The diagnosis of UI resulted from an interdisciplinary conciliating meeting for urinary functional disorders (TOFU), gathering geriatricians and neuro-urologists and was considered as reference. RESULTS 294 consecutive patients (mean age 86.2 ± 6.5 years; 76.5% female) admitted to the ACE unit were screened; 169 were incontinent (57.5%) according to TOFU. The Katz's ADL item identified 106 incontinent patients with 20 false positives; 83 incontinent patients were not identified. If the sensitivity and specificity of the ICIQ-UI-sf were 100.0%, they were, respectively, 50.9 and 84.0% for the Katz's ADL item. Positive and negative predictive values were 100.0% for ICIQ-UI-sf; 81.1 and 55.9% for ADL, respectively. CONCLUSION This study validates the ICIQ-UI-sf as a simple and effective screening tool for UI in vulnerable and complex hospitalized aged patients. It also demonstrates that the "continence" item of the Katz's ADL scale is not sensitive enough for UI screening in this population.
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John G, Avouac J, Piantoni S, Polito P, Fredi M, Cozzi F, Airò P, Truchetet ME, Franceschini F, Allanore Y, Chizzolini C. Prevalence and Disease-Specific Risk Factors for Lower Urinary Tract Symptoms in Systemic Sclerosis: An International Multicenter Study. Arthritis Care Res (Hoboken) 2018; 70:1218-1227. [DOI: 10.1002/acr.23454] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 10/17/2017] [Indexed: 01/19/2023]
Affiliation(s)
- Gregor John
- Hôpital Neuchâtelois, La Chaux-de-Fonds, Switzerland, and Geneva University Hospitals; Geneva Switzerland
| | | | | | | | | | | | | | - Marie-Elise Truchetet
- CNRS-UMR 5164 Immuno Concept, Bordeaux University and Bordeaux Hospital; Bordeaux France
| | | | | | - Carlo Chizzolini
- University Hospital and School of Medicine, University of Geneva; Geneva Switzerland
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18
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Urinary incontinence in home care: a representative multicenter study on prevalence, severity, impact on quality of life, and risk factors. Aging Clin Exp Res 2018; 30:589-594. [PMID: 28836236 DOI: 10.1007/s40520-017-0816-6] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2017] [Accepted: 08/02/2017] [Indexed: 01/20/2023]
Abstract
OBJECTIVES The objective of the study was to determine the prevalence and severity of urinary incontinence and associated factors in patients receiving home care nursing service. METHODS From June to September 2015, a multicenter cross-sectional study was conducted in 923 patients from 102 home care services throughout Germany. The ICIQ-SF was used to determine the characteristics of UI and its impact on QoL. To determine the risks for UI, demographic and social risks, the Barthel Index and medical diagnoses were determined in descriptive and logistic regression analysis. RESULTS The prevalence of UI was 62.5% (95% CI 59.3-65.6). The most common reasons for UI were before getting to the toilet 27.6% and when coughing or sneezing 27.3%. If the amount of leakage was medium (high), the mean of the impact on QoL was 4.9, SD 2.7 (5.0, SD 3.6). If the frequency of UI was higher than once a day (permanent), the mean of the impact on QoL was 4.2, SD 2.7 (4.8, SD 3.2). The results of the logistic regression analysis show the highest odds ratios for mobility-inability to walk (4.49), presence of dementia (2.59), and female sex (1.81). The metric variables age (1.02), Barthel Index (0.93), and BMI (1.05) were also statistically significant. CONCLUSIONS The prevalence of UI in home care in Germany is high. Since UI is strongest associated with (im-) mobility, preserving or regaining patients' mobility should play a central role in providing care to avoid/minimize UI.
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Chong E, Chan M, Lim WS, Ding YY. Frailty Predicts Incident Urinary Incontinence Among Hospitalized Older Adults—A 1-Year Prospective Cohort Study. J Am Med Dir Assoc 2018; 19:422-427. [DOI: 10.1016/j.jamda.2017.12.103] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 12/29/2017] [Indexed: 12/27/2022]
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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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22
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John G, Allanore Y, Polito P, Piantoni S, Fredi M, Avouac J, Franceschini F, Truchetet ME, Cozzi F, Airo P, Chizzolini C. The limited cutaneous form of systemic sclerosis is associated with urinary incontinence: an international multicentre study. Rheumatology (Oxford) 2017; 56:1874-1883. [DOI: 10.1093/rheumatology/kex230] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2017] [Indexed: 12/19/2022] Open
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23
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Krzastek SC, Robinson SP, Young HF, Klausner AP. Improvement in lower urinary tract symptoms across multiple domains following ventriculoperitoneal shunting for idiopathic normal pressure hydrocephalus. Neurourol Urodyn 2017; 36:2056-2063. [PMID: 28185313 DOI: 10.1002/nau.23235] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2016] [Revised: 01/02/2017] [Accepted: 01/09/2017] [Indexed: 01/31/2023]
Abstract
AIMS The purpose of this study was to evaluate the change in lower urinary tract symptoms following ventriculoperitoneal shunting in patients with idiopathic normal pressure hydrocephalus (iNPH). METHODS Lower urinary tract symptoms in patients with new-onset iNPH were prospectively evaluated using validated questionnaires from the International Consultation on Incontinence to assess overactive bladder (ICIq-OAB), incontinence (ICIq-UI), and quality of life (ICIq-LUTqol), as well as the American Urological Association Symptom Score bother scale, prior to and following ventriculoperitoneal shunting for iNPH. Sub-analysis was performed based on gender, age, and medical comorbidities. RESULTS Twenty-three consecutive patients with new-onset iNPH were evaluated prior to, and following, surgical intervention for iNPH via ventriculoperitoneal shunting. Shunting resulted in a significant improvement in urinary urgency, urge incontinence, ability to perform physical activities, and overall quality of life. Women had improvement across more domains than men following shunting, particularly in terms of urinary urgency and overall quality of life. Younger patients experienced significant improvement in scores following shunting as compared to older patients. Patients with two or more medical comorbidities, as well as those with fewer than two comorbidities, reported a significant improvement in overall quality of life. CONCLUSIONS Surgical intervention for iNPH results in significant improvement in urinary symptoms, specifically in terms of urinary urgency and urge incontinence as well as overall quality of life, particularly in women and younger patients.
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Affiliation(s)
- Sarah C Krzastek
- Division of Urology, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Samuel P Robinson
- Division of Urology, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Harold F Young
- Department of Neurosurgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Adam P Klausner
- Division of Urology, Virginia Commonwealth University School of Medicine, Richmond, Virginia
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Schumpf LF, Theill N, Scheiner DA, Fink D, Riese F, Betschart C. Urinary incontinence and its association with functional physical and cognitive health among female nursing home residents in Switzerland. BMC Geriatr 2017; 17:17. [PMID: 28086759 PMCID: PMC5237224 DOI: 10.1186/s12877-017-0414-7] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2016] [Accepted: 01/05/2017] [Indexed: 11/08/2022] Open
Abstract
Background Specific knowledge of urinary incontinence (UI) and its interrelation with physical and cognitive health is essential to working towards prevention of UI and to improving quality of treatment and care. The purpose of this study was to determine the association between UI and the activities of daily living (ADL) hierarchy scale, the cognitive performance scale (CPS) and comorbid conditions. Methods The cross-sectional retrospective analysis of 357 nursing homes in Switzerland was based on data of the Minimum Data Set of the Resident Assessment Instrument 2.0 (RAI-MDS). The analysis examined the effect of ADL hierarchy scale, CPS, joint motion and comorbidities on UI. Women ≥65 years were included (n = 44’811; January 2005 to September 2014) at the time of admission to a nursing home. Statistical analysis was done by means of descriptive statistics and logistic regression analysis. Results The prevalence of UI was 54.7%, the mean ADL hierarchy scale (± SD) 2.42 ± 3.26 (range = 0–6), the mean CPS 1.95 ± 1.67 (range = 0–6). There was a gradual increase in the odds ratio (OR) for UI depending on the ADL hierarchy scale, from the hierarchy scales of “supervised” to “total dependence” of 1.43 – 30.25. For CPS, the OR for UI from “borderline intact” to “very severe impairment” was 1.35 – 5.99. Considering the interaction between ADL and CPS, all ADL hierarchies remained significantly associated with UI, however for CPS this was the case only in the lower hierarchies. Of the 11 examined comorbid conditions, only diabetes mellitus (OR 1.19), dementia (OR 1.01) and arthrosis/arthritis (OR 1.53) were significantly associated with UI. Conclusion The study indicated that impairment in ADL performance is strongly associated with UI, more than CPS performance and comorbidities. Physical more than cognitive training in order to improve or at least stabilize ADL performance could be a way to prevent or reduce the process of developing UI.
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Affiliation(s)
- Lea F Schumpf
- Department of Gynecology, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland.
| | - Nathan Theill
- University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Zurich, Switzerland
| | - David A Scheiner
- Department of Gynecology, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
| | - Daniel Fink
- Department of Gynecology, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
| | - Florian Riese
- University Research Priority Program "Dynamics of Healthy Aging", University of Zurich, Zurich, Switzerland.,Psychiatric University Hospital Zurich, Division of Psychiatry Research and Division of Psychogeriatric Medicine, Zurich, Switzerland
| | - Cornelia Betschart
- Department of Gynecology, University Hospital Zurich, Frauenklinikstrasse 10, 8091, Zurich, Switzerland
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Schluter PJ, Ward C, Arnold EP, Scrase R, Jamieson HA. Urinary incontinence, but not fecal incontinence, is a risk factor for admission to aged residential care of older persons in New Zealand. Neurourol Urodyn 2016; 36:1588-1595. [DOI: 10.1002/nau.23160] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2016] [Accepted: 09/24/2016] [Indexed: 01/19/2023]
Affiliation(s)
- Philip J. Schluter
- School of Health Sciences; University of Canterbury − Te Whare Wānanga o Waitaha; Christchurch New Zealand
- School of Nursing, Midwifery and Social Work; The University of Queensland; Brisbane Australia
| | - Charlotte Ward
- School of Health Sciences; University of Canterbury − Te Whare Wānanga o Waitaha; Christchurch New Zealand
| | | | - Richard Scrase
- Canterbury District Health Board; Older Person's Health; Christchurch New Zealand
| | - Hamish A. Jamieson
- University of Otago; Christchurch New Zealand
- Canterbury District Health Board; Older Person's Health; Christchurch New Zealand
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Damián J, Pastor-Barriuso R, García López FJ, de Pedro-Cuesta J. Urinary incontinence and mortality among older adults residing in care homes. J Adv Nurs 2016; 73:688-699. [DOI: 10.1111/jan.13170] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/02/2016] [Indexed: 01/25/2023]
Affiliation(s)
- Javier Damián
- National Centre for Epidemiology; Carlos III Institute of Health; Madrid Spain
- Consortium for Biomedical Research in Neurodegenerative Diseases (CIBERNED); Madrid Spain
| | - Roberto Pastor-Barriuso
- National Centre for Epidemiology; Carlos III Institute of Health; Madrid Spain
- Consortium for Biomedical Research in Epidemiology and Public Health (CIBERESP); Madrid Spain
| | - Fernando J. García López
- National Centre for Epidemiology; Carlos III Institute of Health; Madrid Spain
- Consortium for Biomedical Research in Neurodegenerative Diseases (CIBERNED); Madrid Spain
| | - Jesús de Pedro-Cuesta
- National Centre for Epidemiology; Carlos III Institute of Health; Madrid Spain
- Consortium for Biomedical Research in Neurodegenerative Diseases (CIBERNED); Madrid Spain
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Krzastek SC, Bruch WM, Robinson SP, Young HF, Klausner AP. Characterization of lower urinary tract symptoms in patients with idiopathic normal pressure hydrocephalus. Neurourol Urodyn 2016; 36:1167-1173. [PMID: 27490149 DOI: 10.1002/nau.23084] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2016] [Accepted: 07/06/2016] [Indexed: 01/28/2023]
Abstract
AIMS The purpose of this study was to evaluate lower urinary tract symptoms (LUTS) in idiopathic normal pressure hydrocephalus (iNPH). METHODS Patients with new-onset iNPH were prospectively evaluated for LUTS via detailed history and physical, and administration of questionnaires from the International Consultation on Incontinence to assess incontinence (ICIq-UI), overactive bladder (ICIq-OAB), and quality of life (ICIq-LUTqol), as well as the American Urological Association Symptom Score bother scale. All patients with moderate-to-severe LUTS were offered urodynamic testing. Sub-analysis was performed based on gender, medical comorbidities, and age. RESULTS Fifty-five consecutive patients with iNPH completed the initial evaluation and surveys. Total urinary incontinence score was mild to moderate (8.71 ± 0.64: 0-21 scale) with 90.9% experiencing leakage and 74.5% reporting urge incontinence. The most common OAB symptom was nocturia (2.2 ± 0.14: 0-4 scale) with urge incontinence the most bothersome (3.71 ± 0.44: 0-10 scale). Quality-of-life impact was moderate (4.47 ± 0.4: 0-10 scale) and American Urological Association Symptom Score bother scale was 2.89 ± 0.22 (0-6 scale). Urodynamics testing revealed 100% detrusor overactivity and mean bladder capacity of 200 mL. Several differences were identified based on gender, medical comorbidities, and age. CONCLUSIONS Patients with iNPH present with mild-moderate incontinence of which nocturia is the most common symptom, urge incontinence the most bothersome, with 100% of patients having detrusor overactivity. Younger patients experienced greater bother related to LUTS. To our knowledge, this is the only prospective evaluation of urinary symptoms in patients with new-onset iNPH.
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Affiliation(s)
- Sarah C Krzastek
- Division of Urology, Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - William M Bruch
- Division of Urology, Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Samuel P Robinson
- Division of Urology, Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Harold F Young
- Department of Neurosurgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia
| | - Adam P Klausner
- Division of Urology, Department of Surgery, Virginia Commonwealth University School of Medicine, Richmond, Virginia
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Radhakrishnan K, Monsen KA, Bae SH, Zhang W. Visual Analytics for Pattern Discovery in Home Care. Clinical Relevance for Quality Improvement. Appl Clin Inform 2016; 7:711-30. [PMID: 27466053 PMCID: PMC5052545 DOI: 10.4338/aci-2016-03-ra-0049] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2006] [Accepted: 06/23/2016] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Visualization can reduce the cognitive load of information, allowing users to easily interpret and assess large amounts of data. The purpose of our study was to examine home health data using visual analysis techniques to discover clinically salient associations between patient characteristics with problem-oriented health outcomes of older adult home health patients during the home health service period. METHODS Knowledge, Behavior and Status ratings at discharge as well as change from admission to discharge that was coded using the Omaha System was collected from a dataset on 988 de-identified patient data from 15 home health agencies. SPSS Visualization Designer v1.0 was used to visually analyze patterns between independent and outcome variables using heat maps and histograms. Visualizations suggesting clinical salience were tested for significance using correlation analysis. RESULTS The mean age of the patients was 80 years, with the majority female (66%). Of the 150 visualizations, 69 potentially meaningful patterns were statistically evaluated through bivariate associations, revealing 21 significant associations. Further, 14 associations between episode length and Charlson co-morbidity index mainly with urinary related diagnoses and problems remained significant after adjustment analyses. Through visual analysis, the adverse association of the longer home health episode length and higher Charlson co-morbidity index with behavior or status outcomes for patients with impaired urinary function was revealed. CONCLUSIONS We have demonstrated the use of visual analysis to discover novel patterns that described high-needs subgroups among the older home health patient population. The effective presentation of these data patterns can allow clinicians to identify areas of patient improvement, and time periods that are most effective for implementing home health interventions to improve patient outcomes.
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Affiliation(s)
- Kavita Radhakrishnan
- Kavita Radhakrishnan, PhD RN MSEE, Assistant Professor, School of Nursing, University of Texas - Austin, 1710 Red River Street,, Austin, TX 78701-1499, UNITED STATES, Tel: (512) 471-7936, Fax: (512) 471 - 3688,
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Young Y, Kalamaras J, Kelly L, Hornick D, Yucel R. Is Aging in Place Delaying Nursing Home Admission? J Am Med Dir Assoc 2016; 16:900.e1-6. [PMID: 26433865 DOI: 10.1016/j.jamda.2015.07.017] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2015] [Revised: 07/29/2015] [Accepted: 07/30/2015] [Indexed: 10/23/2022]
Abstract
OBJECTIVES This study examines whether aging in place (community-based living before admission to a nursing home) delays nursing home admission among New York State home health care recipients. DESIGN Retrospective cohort study (January 2007-December 2012). SETTING New York State. PARTICIPANTS Adults age 65+ who received home health services for at least 2 months before permanent nursing home admission. MEASUREMENT AND ANALYSIS Permanent transition is defined as home care patients who are discharged to and stay at a nursing home for more than 3 months. Data were abstracted from the Minimum Data Set (MDS) and Outcome and Assessment Information Set (OASIS). Descriptive and bivariate Kruskal-Wallis and χ(2) tests were performed. RESULTS The average age of nursing home residents at admission remained steady at 83 years between 2007 and 2012. The proportion of minority populations (Asian, black, Hispanic/Latino) increased, whereas the white population declined (P < .0001). The average length of stay at home increased 8 months, from 17 months in 2007 to 25 months in 2012 (P < .0001). Chronic conditions with significant increases in prevalence during the study period were hypertension (P < .0009), dementia (P < .0001), heart failure (P = .05), urinary incontinence (P < .0001), and bowel incontinence (P < .0001). Increases in functional disabilities requiring extensive human assistance included toileting, dressing, personal hygiene, and transferring (all P < .001). CONCLUSION Home health services enabled recipients to remain at home 8 months longer, thus delaying nursing home entry. Given the increase in prevalence of comorbidities and disability, we anticipate a concomitant increase in support services at the nursing home. These results may inform policy and staffing decisions regarding adjustments in required caregivers' credentials and nurse-patient ratios.
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Affiliation(s)
- Yuchi Young
- Department of Health Policy, Management, and Behavior, School of Public Health, State University of New York at Albany, Albany, NY.
| | - John Kalamaras
- Department of Epidemiology and Biostatistics, School of Public Health, State University of New York at Albany, Albany, NY
| | - Lindsay Kelly
- Department of Health Policy, Management, and Behavior, School of Public Health, State University of New York at Albany, Albany, NY
| | | | - Recai Yucel
- Department of Epidemiology and Biostatistics, School of Public Health, State University of New York at Albany, Albany, NY
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Urinary Incontinence as a Predictor of Death: A Systematic Review and Meta-Analysis. PLoS One 2016; 11:e0158992. [PMID: 27410965 PMCID: PMC4943733 DOI: 10.1371/journal.pone.0158992] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2016] [Accepted: 06/25/2016] [Indexed: 12/16/2022] Open
Abstract
Background The association between urinary incontinence (UI) and increased mortality remains controversial. The objective of our study was to evaluate if this association exists. Methods We performed a systematic review and meta-analysis of observational studies comparing death rates among patients suffering from UI to those without incontinence. We searched in Medline, Embase and the Cochrane library using specific keywords. Studies exploring the post-stroke period were excluded. Hazard ratios (HR) were pooled using models with random effects. We stratified UI by gender and by UI severity and pooled all models with adjustment for confounding variables. Results Thirty-eight studies were retrieved. When compared to non-urinary incontinent participants, UI was associated with an increase in mortality with pooled non adjusted HR of 2.22 (95%CI 1.77–2.78). The risk increased with UI severity: 1.24 (95%CI: 0.79–1.97) for light, 1.71 (95%CI: 1.26–2.31) for moderate, and 2.72 (95%CI: 1.90–3.87) for severe UI respectively. When pooling adjusted measures of association, the resulting HR was 1.27 (95%CI: 1.13–1.42) and increased progressively for light, moderate and severe UI: 1.07 (95%CI: 0.79–1.44), 1.25 (95%CI: 0.99–1.58), and 1.47 (95%CI: 1.03–2.10) respectively. There was no difference between genders. Conclusion UI is a predictor of higher mortality in the general and particularly in the geriatric population. The association increases with the severity of UI and persists when pooling models adjusted for confounders. It is unclear if this association is causative or just reflects an impaired general health condition. As in most meta-analyses of observational studies, methodological issues should be considered when interpreting results.
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Suzuki M, Iguchi Y, Igawa Y, Yoshida M, Sanada H, Miyazaki H, Homma Y. Ultrasound‐assisted prompted voiding for management of urinary incontinence of nursing home residents: Efficacy and feasibility. Int J Urol 2016; 23:786-90. [DOI: 10.1111/iju.13156] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2016] [Accepted: 05/31/2016] [Indexed: 11/29/2022]
Affiliation(s)
- Motofumi Suzuki
- Department of Urology Tokyo Teishin Hospital Tokyo Japan
- Department of Urology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Yasuhiro Iguchi
- Megumi Long‐Term Care Health Facility Departments of Continence Medicine Tokyo Japan
| | - Yasuhiko Igawa
- Department of Continence Medicine Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Mikako Yoshida
- Life Support Technology (Molten) Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Hiromi Sanada
- Gerontological Nursing/Wound Care Management Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Hideyo Miyazaki
- Department of Urology Graduate School of Medicine The University of Tokyo Tokyo Japan
| | - Yukio Homma
- Department of Urology Graduate School of Medicine The University of Tokyo Tokyo Japan
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Wenderlein JM. The Cause Is Reproductive Behavior. DEUTSCHES ARZTEBLATT INTERNATIONAL 2015; 112:612. [PMID: 26396047 PMCID: PMC4581109 DOI: 10.3238/arztebl.2015.0612a] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Hsu A, Conell-Price J, Stijacic Cenzer I, Eng C, Huang AJ, Rice-Trumble K, Lee SJ. Predictors of urinary incontinence in community-dwelling frail older adults with diabetes mellitus in a cross-sectional study. BMC Geriatr 2014; 14:137. [PMID: 25514968 PMCID: PMC4274753 DOI: 10.1186/1471-2318-14-137] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2014] [Accepted: 12/11/2014] [Indexed: 12/17/2022] Open
Abstract
Background Diabetes mellitus is a potent risk factor for urinary incontinence. Previous studies of incontinence in patients with diabetes have focused on younger, healthier patients. Our objective was to characterize risk factors for urinary incontinence among frail older adults with diabetes mellitus in a real-world clinical setting. Methods We performed a cross-sectional analysis on enrollees at On Lok (the original Program for All-Inclusive Care of the Elderly) between October 2004 and December 2010. Enrollees were community-dwelling, nursing home-eligible older adults with diabetes mellitus (N = 447). Our outcome was urinary incontinence measures (n = 2602) assessed every 6 months as “never incontinent”, “seldom incontinent” (occurring less than once per week), or “often incontinent” (occurring more than once per week). Urinary incontinence was dichotomized (“never” versus “seldom” and “often” incontinent). We performed multivariate mixed effects logistic regression analysis with demographic (age, gender and ethnicity), geriatric (dependence on others for ambulation or transferring; cognitive impairment), diabetes-related factors (hemoglobin A1c level; use of insulin and other glucose-lowering medications; presence of renal, ophthalmologic, neurological and peripheral vascular complications), depressive symptoms and diuretic use. Results The majority of participants were 75 years or older (72%), Asian (65%) and female (66%). Demographic factors independently associated with incontinence included older age (OR for age >85, 3.13, 95% CI: 2.15-4.56; Reference: Age <75) and African American or other race (OR 2.12, 95% CI: 1.14-3.93; Reference: Asian). Geriatric factors included: dependence on others for ambulation (OR 1.48, 95% CI: 1.19-1.84) and transferring (OR 2.02, 95% CI: 1.58-2.58) and being cognitively impaired (OR 1.41, 95% CI: 1.15-1.73). Diabetes-related factors associated included use of insulin (OR 2.62, 95% CI: 1.67-4.13) and oral glucose-lowering agents (OR 1.81, 95% CI: 1.33-2.45). Urinary incontinence was not associated with gender, hemoglobin A1c level or depressive symptoms. Conclusions Geriatric factors such as the inability to ambulate or transfer independently are important predictors of urinary incontinence among frail older adults with diabetes mellitus. Clinicians should address mobility and cognitive impairment as much as diabetes-related factors in their assessment of urinary incontinence in this population.
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Affiliation(s)
- Amy Hsu
- VA Quality Scholars Fellow, Geriatrics and Extended Care, San Francisco VA Medical Center, 4150 Clement Street, 181G, San Francisco, CA 94122, USA.
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