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Zhang Y, Fang D, Luo Y, Wang C, Wan L, Cao Y, Xin H, Ding H. A large cross sectional study on diaper utilization and beneficial role in outdoor activity and emotions among incontinence elderly people. Sci Rep 2024; 14:6358. [PMID: 38491120 PMCID: PMC10943191 DOI: 10.1038/s41598-024-57055-5] [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: 01/26/2024] [Accepted: 03/13/2024] [Indexed: 03/18/2024] Open
Abstract
This study was designed based on a cross-sectional investigation conducted Shanghai, China. Demographic characteristics, diaper utilization, Activities of Daily Living (ADL) and emotion were collected by Unified Needs Assessment Form for Elderly Care Questionnaire. Cognition function was assessed by Mini-mental State Examination (MMSE) scale. Multivariate logistic regression was used for statistical analysis. The diaper utilization rate was 31.2%. Female, higher level of education, poorer ADL and cognition, more severe incontinence and financial dependence on others were facilitating factors for diaper usage (P < 0.05). The possibility of using diaper differed according to the intimacy of caregivers. Among incontinent individuals with relatively good ADL and cognition level, diaper utilization can significantly decrease the risk of going out only once a month (OR: 2.63 vs 4.05), and going out less than once a month (OR: 5.32 vs 6.53). Incontinence people who going out at least once a week had a lower risk of some negative emotion. Significantly, diaper utilization further decreased this risk. In conclusion, for incontinence elderly people with relatively independent ability, proper use of diaper may improve the frequency of outdoor activity and emotion. Nevertheless, diaper utilization should be decided based on elderly people's own will.
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Affiliation(s)
- Yunwei Zhang
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, 200031, People's Republic of China
| | - Dawei Fang
- Department of Cardiology, Quanzhou First Hospital Affiliated to Fujian Medical University, Quanzhou, Fujian, People's Republic of China
| | - Yashuang Luo
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, 200031, People's Republic of China
| | - Changying Wang
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, 200031, People's Republic of China
| | - Lingshan Wan
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, 200031, People's Republic of China
| | - Yifan Cao
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, 200031, People's Republic of China
| | - Hongyun Xin
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, 200031, People's Republic of China
| | - Hansheng Ding
- Shanghai Health Development Research Center (Shanghai Medical Information Center), Shanghai, 200031, People's Republic of China.
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Jerez-Roig J, Farrés-Godayol P, Yildirim M, Escribà-Salvans A, Moreno-Martin P, Goutan-Roura E, Rierola-Fochs S, Romero-Mas M, Booth J, Skelton DA, Giné-Garriga M, Minobes-Molina E. Prevalence of urinary incontinence and associated factors in nursing homes: a multicentre cross-sectional study. BMC Geriatr 2024; 24:169. [PMID: 38368318 PMCID: PMC10874568 DOI: 10.1186/s12877-024-04748-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2023] [Accepted: 01/25/2024] [Indexed: 02/19/2024] Open
Abstract
BACKGROUND Urinary incontinence (UI) is a common geriatric syndrome with high health and socio-economic impacts in nursing home (NH) residents. OBJECTIVES To estimate the prevalence and types of UI and its associated factors in older people living in NHs in Central Catalonia (Spain). We also determined the proportion of residents who were receiving behavioural strategies to prevent/manage UI. DESIGN AND SETTING Cross-sectional study in 5 NHs conducted from January to March 2020. METHODS We included consenting residents aged 65 + permanently living in the NHs. Residents who were hospitalized, in a coma or palliative care were excluded. UI was assessed using Section H of the Minimum Data Set. Sociodemographic and health-related variables were examined. Descriptive, bivariate, and multivariate (logistic regression) analyses were performed. RESULTS We included 132 subjects (82.6% women), mean age of 85.2 (SD = 7.4) years. The prevalence of UI was 76.5% (95% CI: 68.60-82.93). The most common type was functional UI (45.5%), followed by urgency UI (11.4%). Only 46.2% of residents received at least one behavioural strategy to manage UI. Most sedentary behaviour (SB) variables presented a p-value lower than 0.001 in the bivariate analyses, but none remained in the final model. Moderate-severe cognitive impairment (OR = 4.44, p =.003), anticholinergic activity (OR = 3.50, p =.004) and risk of sarcopenia using SARC-F (OR = 2.75, p =.041) were associated with UI. CONCLUSIONS The prevalence of UI was high in this sample of NH residents compared to the literature, yet less than half received prompted voiding as a strategy to prevent/reduce UI.UI was associated with cognitive impairment, anticholinergic activity, and risk of sarcopenia.
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Affiliation(s)
- Javier Jerez-Roig
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
| | - Pau Farrés-Godayol
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain.
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain.
| | - Meltem Yildirim
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
| | - Anna Escribà-Salvans
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
| | - Pau Moreno-Martin
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
| | - Ester Goutan-Roura
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
- Research group on Tissue Repair and Regeneration Laboratory (TR2Lab), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic- Central University of Catalonia (UVic-UCC), Barcelona, Spain
| | - Sandra Rierola-Fochs
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
| | - Montse Romero-Mas
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
| | - Joanne Booth
- Research Centre for Health (ReaCH), School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Dawn A Skelton
- Research Centre for Health (ReaCH), School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Maria Giné-Garriga
- Blanquerna Faculty of Psychology, Education and Sport Sciences, Ramon Llull University, Barcelona, Spain
- Blanquerna Faculty of Health Sciences, Ramon Llull University, Barcelona, Spain
| | - Eduard Minobes-Molina
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O), Faculty of Health Sciences and Welfare, Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família, 7, Barcelona, Vic, 08500, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS- CC), Barcelona, Vic, Spain
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Moradinasab S, Iravani M, Mousavi P, Cheraghian B, Molavi S. Effect of cognitive-behavioral therapy on sexual self-esteem and sexual function of reproductive-aged women suffering from urinary incontinence. Int Urogynecol J 2023; 34:1753-1763. [PMID: 36715741 PMCID: PMC9885913 DOI: 10.1007/s00192-023-05460-1] [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: 11/09/2022] [Accepted: 12/24/2022] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Patients with urinary incontinence may fear sexual activity due to the unpredictability of urine leakage during intercourse. Given the effective role of cognitive-behavioral therapy in correcting negative thoughts and attitudes, this study was aimed to investigate the effect of cognitive-behavioral therapy on sexual self-esteem and sexual function of reproductive-aged women suffering from urinary incontinence. METHODS This study was a randomized controlled clinical trial conducted on 84 reproductive-aged women (18 to 45 years old) with urinary incontinence who referred to Health Centers of Dezful, Iran. After random allocation, the participants were divided into two groups of intervention and control (n = 42). The intervention group attended eight 45-min sessions of cognitive-behavioral therapy, while the control group received only routine interventions. The International Consultation on Incontinence Questionnaire-Short Form (ICIQ-SF), the Scale of Self-Esteem Index for Women-Short-form (SSEL-W-SF), and the Pelvic Organ Prolapse/Urinary Incontinence Sexual Function Questionnaire (PISQ-12) were completed before, immediately after, and 4 weeks after the end of the intervention by patients in both groups. RESULTS The overall scores of sexual self-esteem and sexual function immediately and 4 weeks after the end of the intervention showed a statistically significant difference in the intervention group compared to the control group (p < 0.001). Also, the results showed that in women with urinary incontinence, an increase in the sexual self-esteem score is associated with an increase in the sexual function score (r = 0.9), p < 0.001). CONCLUSION Cognitive-behavioral therapy was found to increase sexual self-esteem and improve sexual function in reproductive-aged women suffering from urinary incontinence.
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Affiliation(s)
- Salimeh Moradinasab
- Midwifery Department, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mina Iravani
- Reproductive Health Promotion Research Center, Midwifery Department, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Parvaneh Mousavi
- Midwifery Department, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Bahman Cheraghian
- Department of Biostatistics and Epidemiology, School of Health, Alimentary Tract Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Shahla Molavi
- Health Psychology, Nursing and Midwifery School, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
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Hassani D, Koelper N, Borodyanskaya Y, Arya NG, Rao H, Andy U. Cognitive function following surgery for pelvic organ prolapse. Neurourol Urodyn 2022; 41:1853-1861. [PMID: 36047412 PMCID: PMC9633552 DOI: 10.1002/nau.25035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 07/29/2022] [Accepted: 08/16/2022] [Indexed: 11/06/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Older women are at higher risk for cognitive dysfunction following surgery. We hypothesized that for women undergoing pelvic organ prolapse (POP) surgery, memory function would not be significantly different at delayed postoperative assessment compared to baseline. OBJECTIVE We sought to compare performance on tests of various neurocognitive domains before and after surgery for POP. METHODS A prospective cohort study was conducted with women, aged 60 years and older who were undergoing surgery for POP. A battery of highly sensitive neurocognitive tests was administered preoperatively (baseline), on postoperative day 1 (postoperative visit 1, POV1), and at the first postoperative clinic visit 4-6 weeks after surgery (postoperative visit 2, POV2). The test battery included the scene-encoding memory task, the n-back task, the Iowa gambling task, the balloon analogue risk task, and the psychomotor vigilance task. These tests assessed the neurocognitive subdomains of episodic memory, working memory, decision-making, risk-taking, and sustained attention. Two score comparisons were made: between baseline and POV1, and between baseline and POV2. RESULTS In 29 women, performance on the scene-encoding memory task was worse at POV1 than at baseline (2.22 ± 0.4 vs. 2.45 ± 0.6, p < 0.05) but was better than baseline at POV2 (2.7 ± 0.7 vs. 2.45 ± 0.6, p < 0.05). Similarly, performance on the psychomotor vigilance test was worse at POV1 than at baseline (p < 0.01) but there was no difference at POV2. There was no difference in performance on the Iowa gambling test, n-back test, and balloon analogue risk tasks between baseline and any postoperative visit. CONCLUSION Cognitive test scores did not worsen significantly between baseline and delayed postoperative assessments in older women undergoing surgery for POP.
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Affiliation(s)
- Daisy Hassani
- University of Pennsylvania Department of Obstetrics and Gynecology, Division of Urogynecology and Pelvic Reconstructive Surgery
| | - Nathanael Koelper
- Department of Obstetrics and Gynecology, Center for Research on Reproduction and Women's Health (N.K.), University of Pennsylvania Perelman School of Medicine, Philadelphia
| | - Yelizaveta Borodyanskaya
- University of Pennsylvania Department of Obstetrics and Gynecology, Division of Urogynecology and Pelvic Reconstructive Surgery
| | | | - Hengyi Rao
- University of Pennsylvania Perelman School of Medicine, Department of Neurology
| | - Uduak Andy
- University of Pennsylvania Department of Obstetrics and Gynecology, Division of Urogynecology and Pelvic Reconstructive Surgery
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Egbujie BA, Northwood M, Turcotte LA, McArthur C, Berg K, Heckman GA, Wagg AS, Hirdes JP. Predictors of improvement in urinary incontinence in the postacute setting: A Canadian cohort study. Neurourol Urodyn 2022; 41:1749-1763. [PMID: 36040456 PMCID: PMC9805031 DOI: 10.1002/nau.25018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2022] [Revised: 07/16/2022] [Accepted: 07/21/2022] [Indexed: 01/09/2023]
Abstract
PURPOSE To determine factors associated with improvement in urinary incontinence (UI) for long-stay postacute, complex continuing care (CCC) patients. DESIGN A retrospective cohort investigation of patients in a CCC setting using data obtained from the Canadian Institute for Health Information's Continuing Care Reporting System collected with interRAI Minimum Data Set 2.0. SETTING AND PARTICIPANTS Individuals aged 18 years and older, were admitted to CCC hospitals in Ontario, Canada, between 2010 and 2018. METHODS Multivariable logistic regression was used to determine the independent effects of predictors on UI improvement, for patients who were somewhat or completely incontinent on admission and therefore had the potential for improvement. RESULTS The study cohort consisted of 18 584 patients, 74% (13 779) of which were somewhat or completely incontinent upon admission. Among those patients with potential for improvement, receiving bladder training, starting a new medication 90 days prior (odds ratio, OR: 1.54 [95% confidence interval, CI: 1.36-1.75]), and triggering the interRAI Urinary Incontinence Clinical Assessment Protocol to facilitate improvement (OR: 1.36 [95% CI: 1.08-1.71]) or to prevent decline (OR: 1.32 [95% CI: 1.13-1.53]) were the strongest predictors of improvement. Conversely, being totally dependent on others for transfer (OR: 0.62 [95% CI: 0.42-0.92]), is rarely or never understood (OR: 0.65 [95% CI: 0.50-0.85]), having a major comorbidity count of ≥3 (OR: 0.72 [95% CI: 0.59-0.88]), Parkinson's disease, OR: 0.77 (95% CI: 0.62-0.95), Alzheimer/other dementia, OR: 0.83 (95% CI: 0.74-0.93), and respiratory infections, OR: 0.57 (95% CI: 0.39-0.85) independently predicted less likelihood of improvement in UI. CONCLUSIONS AND IMPLICATIONS Findings of this study suggest that improving physical function, including bed mobility, and providing bladder retraining have strong positive impacts on improvement in UI for postacute care patients. Evidence generated from this study provides useful care planning information for care providers in identifying patients and targeting the care that may lead to better success with the management of UI.
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Affiliation(s)
| | | | - Luke A. Turcotte
- School of Public Health SciencesUniversity of WaterlooWaterlooOntarioCanada
| | - Caitlin McArthur
- School of PhysiotherapyDalhousie UniversityHalifaxNova ScotiaCanada
| | - Katherine Berg
- Department of Physical TherapyUniversity of TorontoTorontoOntarioCanada
| | - George A. Heckman
- School of Public Health SciencesUniversity of WaterlooWaterlooOntarioCanada,Schlegel Research Chair in Geriatric MedicineSchlegel‐University of Waterloo Research Institute for AgingWaterlooOntarioCanada
| | - Adrian S. Wagg
- Department of Medicine, Division of Geriatric MedicineUniversity of AlbertaEdmontonAlbertaCanada
| | - John P. Hirdes
- School of Public Health SciencesUniversity of WaterlooWaterlooOntarioCanada
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Rodrigues EA, Christie GJ, Farzan F, Moreno S. Does cognitive aging follow an orchid and dandelion phenomenon? Front Aging Neurosci 2022; 14:986262. [PMID: 36299615 PMCID: PMC9588970 DOI: 10.3389/fnagi.2022.986262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Accepted: 09/15/2022] [Indexed: 11/18/2022] Open
Abstract
Cognitive reserve reflects the brain’s intrinsic adaptive capacity against the neurodegenerative effects of aging. The maintenance or enhancement of the brain’s cognitive reserve plays a crucial role in mitigating the severity of pathologies associated with aging. A new movement, social prescribing, which focuses on prescribing lifestyle activities as a treatment for patients, is growing in popularity as a solution against aging pathologies. However, few studies have demonstrated a clear impact of lifestyle activities on individual cognitive health, outside of floor and ceiling effects. Understanding who benefits from which lifestyle factors remains unclear. Here, we investigated the potential effects of lifestyle activities on individuals’ cognitive health from more than 3,530 older adults using a stratification method and advanced analysis technique. Our stratification methods allowed us to observe a new result: older adults who had relatively average cognitive scores were not impacted by lifestyle factors. By comparison, older adults with very high or very low cognitive scores were highly impacted by lifestyle factors. These findings expand the orchid and dandelion theory to the aging field, regarding the biological sensitivity of individuals to harmful and protective environmental effects. Our discoveries demonstrate the role of individual differences in the aging process and its importance for social prescribing programs.
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Affiliation(s)
- Emma A. Rodrigues
- School of Interactive Arts and Technology, Simon Fraser University, Surrey, BC, Canada
| | | | - Faranak Farzan
- School of Mechatronics and Systems Engineering, Simon Fraser University, Surrey, BC, Canada
| | - Sylvain Moreno
- School of Interactive Arts and Technology, Simon Fraser University, Surrey, BC, Canada
- Circle Innovation, Surrey, BC, Canada
- *Correspondence: Sylvain Moreno,
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Heltty H. Patient, Family, and Peer Engagement in Nursing Care as an Effort to Improve the Functional Independence of Post-stroke Urinary Incontinence Patients: A Cross-Sectional Study. Cureus 2022; 14:e26649. [PMID: 35949768 PMCID: PMC9357258 DOI: 10.7759/cureus.26649] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction The engagement of patients, family members, and peers is one approach that can be taken to improve the patient’s health status. This study aimed to investigate the relationship between patient, family, and peer involvement in nursing care to improve the functional independence of post-stroke urinary incontinence (UI) patients. Methods This cross-sectional descriptive design study was conducted in three hospitals in Kota Kendari, Sulawesi Tenggara, Indonesia. A total of 104 patients were selected using a simple random sampling method. Data were collected during the research period through a survey and observation. Data were analyzed using descriptive analysis and the Mann-Whitney test. Results There was a statistically significant difference in the motor subscale of the Functional Independence Measure (motor-FIM) domain (p<0.05). Based on the results of the analysis, there was a relationship between each motor-FIM domain in the engagement group. Conclusions The involvement of patients, families, and peers in patient care needs to be comprehensively improved in an effort to increase patient independence, which in turn can improve the quality of life of post-stroke urinary incontinence patients.
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Hoedl M, Eglseer D. Associations among incontinence, incontinence‐associated dermatitis and pressure injuries in older nursing home residents. INTERNATIONAL JOURNAL OF UROLOGICAL NURSING 2022. [DOI: 10.1111/ijun.12321] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- Manuela Hoedl
- Medical University of Graz Institute of Nursing Science Graz Styria Austria
| | - Doris Eglseer
- Medical University of Graz Institute of Nursing Science Graz Styria Austria
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Sayed MA, Fouad AL, Belal S, Breboneria BJL, Abobaker RM. Effect of Urogenital Infection Educational Program on Women Knowledge and Practices. Open Nurs J 2022. [DOI: 10.2174/18744346-v16-e2112230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Urogenital infection is generally regarded as a silent epidemic. It is one of the major public health problems among women that causes a considerable proportion of gynecological morbidity and maternal mortality in developing countries.
Aim:
The aim of this study is to evaluate the effect of an educational program on women’s knowledge and practices about urogenital infection.
Methods:
A quasi-experimental research design was utilized in this study and was implemented at El Hadaka Maternity and Children’s Hospital (MCH) in Fayoum, Egypt. A purposive sample consisting of 50 women with ages ranging from 30 to 45 years old was considered for this study.
Two tools were used to conduct this study: a structured interview questionnaire consisting of the respondents’ demographic characteristics, knowledge, and practices regarding urogenital infection and a scale that aimed to assess their lifestyle.
Results:
The results revealed that 96% of the women have unsatisfactory knowledge about urogenital infection during the pre-intervention stage, 94% of them have satisfactory knowledge post-intervention, and 90% of them have satisfactory knowledge at follow-up, with a highly statistically significant difference at p-value < 0.01. The results also showed that 82% of the respondents have unsatisfactory practices at pre-intervention, 96% have satisfactory practices at post-intervention, and 98% of them have satisfactory practices at follow-up, with a highly statistically significant difference at p-value < 0.01.
Conclusion:
There was a significant improvement in women's knowledge and practices related to urogenital infection post-intervention and at follow-up with a p-value < 0.01. Likewise, a high positive correlation between total lifestyle, level of knowledge, and practices was noted during the pretest with a p-value < 0.01.
There is a need to provide different educational programs regarding knowledge and self-care practices for women with urogenital infection in different women's care settings.
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Sayed MA, Fouad AL, Belal S, Breboneria BJL, Abobaker RM. Effect of Urogenital Infection Educational Program on Women Knowledge and Practices. Open Nurs J 2022. [DOI: 10.2174/18744346-v16-2112230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Background:
Urogenital infection is generally regarded as a silent epidemic. It is one of the major public health problems among women that causes a considerable proportion of gynecological morbidity and maternal mortality in developing countries.
Aim:
The aim of this study is to evaluate the effect of an educational program on women’s knowledge and practices about urogenital infection.
Methods:
A quasi-experimental research design was utilized in this study and was implemented at El Hadaka Maternity and Children’s Hospital (MCH) in Fayoum, Egypt. A purposive sample consisting of 50 women with ages ranging from 30 to 45 years old was considered for this study.
Two tools were used to conduct this study: a structured interview questionnaire consisting of the respondents’ demographic characteristics, knowledge, and practices regarding urogenital infection and a scale that aimed to assess their lifestyle.
Results:
The results revealed that 96% of the women have unsatisfactory knowledge about urogenital infection during the pre-intervention stage, 94% of them have satisfactory knowledge post-intervention, and 90% of them have satisfactory knowledge at follow-up, with a highly statistically significant difference at p-value < 0.01. The results also showed that 82% of the respondents have unsatisfactory practices at pre-intervention, 96% have satisfactory practices at post-intervention, and 98% of them have satisfactory practices at follow-up, with a highly statistically significant difference at p-value < 0.01.
Conclusion:
There was a significant improvement in women's knowledge and practices related to urogenital infection post-intervention and at follow-up with a p-value < 0.01. Likewise, a high positive correlation between total lifestyle, level of knowledge, and practices was noted during the pretest with a p-value < 0.01.
There is a need to provide different educational programs regarding knowledge and self-care practices for women with urogenital infection in different women's care settings.
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Urinary Incontinence and Its Association with Physical and Psycho-Cognitive Factors: A Cross-Sectional Study in Older People Living in Nursing Homes. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19031500. [PMID: 35162524 PMCID: PMC8835480 DOI: 10.3390/ijerph19031500] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 01/24/2022] [Accepted: 01/26/2022] [Indexed: 02/01/2023]
Abstract
Urinary incontinence (UI) is a common geriatric syndrome affecting bladder health and is especially prevalent in nursing homes (NHs). The aim of the study was to determine the prevalence of UI and its associated factors in five Spanish NHs. UI (measured with Minimum Data Set 3.0), sociodemographic, and health-related variables were collected. Chi-square (or Fisher's) or Student's t-test (or Mann Whitney U) for bivariate analysis were used, with Prevalence Ratio (PR) as an association measure. The prevalence of UI was 66.1% (CI:95%, 53.6-77.2) in incontinent (n = 45, mean age 84.04, SD = 7.7) and continent (n = 23, mean age 83.00, SD = 7.7) groups. UI was significantly associated with frailty (PR = 1.84; 95%CI 0.96-3.53), faecal incontinence (PR = 1.65; 95%CI 1.02-2.65), anxiety (PR = 1.64; 95%CI 1.01-2.66), physical performance (PR = 1.77; 95%CI 1.00-3.11), and cognitive state (PR = 1.95; 95%CI 1.05-3.60). Statistically significant differences were found between incontinent and continent NH residents for limitations in activities of daily living (ADL), mobility, quality of life, sedentary behaviour, and handgrip strength. It can be concluded that two out of three of the residents experienced UI, and significant associated factors were mainly physical (sedentary behaviour, frailty, physical performance, ADL limitations, mobility, faecal incontinence, and handgrip strength) followed by psycho-cognitive factors (cognition, anxiety, and quality of life).
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Prevalence and Risk Factors of Urinary Incontinence Among Elderly Adults in Rural China: A Cross-Sectional Survey. J Wound Ostomy Continence Nurs 2022; 49:78-86. [PMID: 35040817 DOI: 10.1097/won.0000000000000829] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
PURPOSE The purpose of this study was to explore the prevalence of urinary incontinence (UI) and several subtypes: (stress, urge, and mixed UI) and the influence of multiple factors on the likelihood of UI. DESIGN Epidemiological study based on cross-sectional data collection. SUBJECTS AND SETTING The sample comprised 1279 inhabitants 65 years and older residing in 10 villages randomly selected from the Shanxi province, located in North China. METHODS The presence and types of UI were assessed using the International Consultation of Incontinence Questionnaire-Short Form. Sociodemographic parameters were also recorded, along with data on lifestyle, bowel function, and medical conditions. The Activity of Daily Living Scale and Mini-Mental State Examination instruments were used to evaluate physical and cognitive functions, respectively. A multivariate logistic regression model with the backward method was employed to identify factors associated with UI. RESULTS The prevalence of any UI among the rural Chinese elderly 65 years and older was 46.8%, with a female predominance (56.3% in females vs 35.0% in males). The most common incontinence subtype in women was mixed UI (n = 170, 24.0%), followed by stress UI (n = 131, 18.5%) and urge UI (n = 97, 13.7%). The most prevalent form of UI in males was urge UI (n = 190, 33.2%), followed by stress UI (n = 5, 0.9%) and mixed UI (n = 5, 0.9%). Less than one quarter of respondents (17%, n = 102) of participants with UI had consulted a doctor. Multivariate analysis found that poorer physical function, poor quality of sleep, and fecal incontinence were common factors associated with UI in both women and men. In women, higher body mass index and constipation were also independent correlates, as were poor vision and heart disease in men. Poorer physical function was associated with all UI subtypes. For female stress UI, poorer cognitive status, tea drinking, and hypertension also emerged as independent risk factors. Heart disease was an independent risk factor in both female and male urge UI; as was consumption of a non-plant-based diet for female mixed and urge UI; nonfarmer and traumatic brain injury for female urge UI; and poor vision and fecal incontinence in male urge UI. CONCLUSIONS Chinese rural citizens showed a high UI prevalence, but only a small proportion had consulted a health care provider. Physical function decline was the most important contributor to UI among participants. Individualized intervention programs targeting modifiable risk factors among high-risk populations should be developed.
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Barichello T, Generoso JS, Singer M, Dal-Pizzol F. Biomarkers for sepsis: more than just fever and leukocytosis-a narrative review. Crit Care 2022; 26:14. [PMID: 34991675 PMCID: PMC8740483 DOI: 10.1186/s13054-021-03862-5] [Citation(s) in RCA: 119] [Impact Index Per Article: 59.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Accepted: 12/08/2021] [Indexed: 02/08/2023] Open
Abstract
A biomarker describes a measurable indicator of a patient's clinical condition that can be measured accurately and reproducibly. Biomarkers offer utility for diagnosis, prognosis, early disease recognition, risk stratification, appropriate treatment (theranostics), and trial enrichment for patients with sepsis or suspected sepsis. In this narrative review, we aim to answer the question, "Do biomarkers in patients with sepsis or septic shock predict mortality, multiple organ dysfunction syndrome (MODS), or organ dysfunction?" We also discuss the role of pro- and anti-inflammatory biomarkers and biomarkers associated with intestinal permeability, endothelial injury, organ dysfunction, blood–brain barrier (BBB) breakdown, brain injury, and short and long-term mortality. For sepsis, a range of biomarkers is identified, including fluid phase pattern recognition molecules (PRMs), complement system, cytokines, chemokines, damage-associated molecular patterns (DAMPs), non-coding RNAs, miRNAs, cell membrane receptors, cell proteins, metabolites, and soluble receptors. We also provide an overview of immune response biomarkers that can help identify or differentiate between systemic inflammatory response syndrome (SIRS), sepsis, septic shock, and sepsis-associated encephalopathy. However, significant work is needed to identify the optimal combinations of biomarkers that can augment diagnosis, treatment, and good patient outcomes.
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Affiliation(s)
- Tatiana Barichello
- Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil. .,Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, The University of Texas Health Science Center at Houston (UTHealth), Houston, TX, 77054, USA.
| | - Jaqueline S Generoso
- Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
| | - Mervyn Singer
- Bloomsbury Institute of Intensive Care Medicine, Division of Medicine, University College London, London, UK
| | - Felipe Dal-Pizzol
- Laboratory of Experimental Pathophysiology, Graduate Program in Health Sciences, University of Southern Santa Catarina (UNESC), Criciúma, SC, Brazil
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14
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Martinez A, Rodriguez MA, Al Snih S. Factors Associated With Urgency Urinary Incontinence Among Older Mexican American Women Aged 65 years and Older. Gerontol Geriatr Med 2022; 8:23337214221119061. [PMID: 36046579 PMCID: PMC9421023 DOI: 10.1177/23337214221119061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2022] [Revised: 07/08/2022] [Accepted: 07/25/2022] [Indexed: 11/16/2022] Open
Abstract
The purpose of this study was to determine which socio-demographic, clinical, or functional factors are associated with urgency urinary incontinence (UUI) over 20-years of follow-up in a community-dwelling sample of Mexican American women aged 65 years and older without UUI at baseline. We included 1,358 women participants from the Hispanic Established Population for the Epidemiologic Study of the Elderly study conducted in the southwestern of US (Arizona, California, Colorado, New Mexico, and Texas). Measures included self-reported UUI, socio-demographics, smoking status, body mass index, medical conditions, depressive symptoms, physical and cognitive function, and handgrip strength. We used generalized estimating equation models to estimate the odds ratio (OR) and 95% Confidence Interval (CI) of UUI as a function of socioeconomic, clinical, and functional factors. Self-reported UUI increased from 3.1% to 21.9% from baseline (1993/1994) to follow-up (2012/2013). Current smokers, obesity, arthritis, previous heart attacks, and depressive symptoms were factors associated with greater odds of UUI over time. Identification of these factors can help clinicians determine those at high risk of developing UUI. Preventing and/or treating the risk factors early may delay UUI and increase quality of life in this underserved population.
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Affiliation(s)
- Ariza Martinez
- The University of Texas Medical Branch, Galveston, TX, USA
| | | | - Soham Al Snih
- The University of Texas Medical Branch, Galveston, TX, USA
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15
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Steenstrup B, Lopes F, Cornu JN, Gilliaux M. Cognitive-behavioral therapy and urge urinary incontinence in women. A systematic review. Int Urogynecol J 2021; 33:1091-1101. [PMID: 34716765 DOI: 10.1007/s00192-021-04989-3] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Accepted: 08/24/2021] [Indexed: 12/25/2022]
Abstract
INTRODUCTION AND HYPOTHESIS UUI co-exists with numerous health conditions, having a substantial negative impact on health-related quality of life and mental health. Cognitive-behavioral therapy (CBT) could help patients manage these problems by changing the way they think and behave. METHODS We carried out a systematic review of the literature assessing the modalities and effects of CBT as a stand-alone strategy, without adding PFMT, on symptoms and clinical signs, in women with UUI. Our secondary objective was to report modalities and effects of CBT on health-related quality of life, psychological symptoms and patient-reported satisfaction. The PRISMA methodology was used to carry out this systematic review. A literature search was conducted in PubMed, PEDro, Web of Science and Cochrane Library databases from inception to December 2020. The PICO approach was used to determine the eligibility criteria. RESULTS Twelve papers were included in the present review which showed beneficial effects on both symptom severity (p < 0.05) and more subjective areas such as quality of life, psychological symptoms or patient satisfaction level (p < 0.05), respectively). However, results on the effectiveness of CBT on clinical signs remains conflicting. CONCLUSION Based on the available literature, this review suggested a high level of evidence for the effectiveness of CBT on symptom severity and a moderate level of evidence for the effectiveness of CBT on quality of life, psychological symptoms and patient satisfaction. However, we highlighted no evidence for the effects of CBT on clinical signs.
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Affiliation(s)
| | - Floriane Lopes
- La Musse Physiotherapy Training Institute, Saint-Sébastien-de-Morsent, France
| | | | - Maxime Gilliaux
- Clinical Research Department, La Musse Hospital, Saint-Sébastien-de-Morsent, France.,CETAPS Laboratory, Rouen University, EA, 3882, Rouen, France
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16
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Ege S. [Urinary Continence and Mobility - two sides of the same coin]. Dtsch Med Wochenschr 2021; 146:959-965. [PMID: 34344030 DOI: 10.1055/a-1405-3828] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
Urinary incontinence and gait disorders are common health related problems that occur especially in old age. Therefore they are called geriatric syndromes. Do they develop independently or is there an association? Do improvements of urinary incontinence result in reduced gait disorders and vice versa? It seems, that there is an interrelation between urinary incontinence and gait disorders. And further, both syndroms seem to interact closely and can be influenced by improvements of each other. Knowing and recognizing the interaction of micturition and physical performance is essential to working towards prevention of UI and to improving quality of treatment and quality of life.
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17
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Booth J, Aucott L, Cotton S, Davis B, Fenocchi L, Goodman C, Hagen S, Harari D, Lawrence M, Lowndes A, Macaulay L, MacLennan G, Mason H, McClurg D, Norrie J, Norton C, O'Dolan C, Skelton D, Surr C, Treweek S. Tibial nerve stimulation compared with sham to reduce incontinence in care home residents: ELECTRIC RCT. Health Technol Assess 2021; 25:1-110. [PMID: 34167637 PMCID: PMC8273680 DOI: 10.3310/hta25410] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Urinary incontinence is prevalent in nursing and residential care homes, and has a profound impact on residents' dignity and quality of life. Treatment options are limited in these care contexts and care homes predominantly use absorbent pads to contain incontinence, rather than actively treat it. Transcutaneous posterior tibial nerve stimulation is a non-invasive, safe, low-cost intervention that is effective in reducing urinary incontinence in adults. OBJECTIVE To determine the clinical effectiveness of transcutaneous posterior tibial nerve stimulation to treat urinary incontinence in care home residents and to determine the associated costs of the treatment. DESIGN A multicentre, pragmatic, participant and outcome assessor-blind, randomised placebo-controlled trial. SETTING A total of 37 UK residential and nursing care homes. PARTICIPANTS Care home residents with at least weekly urinary incontinence that is contained using absorbent pads and who are able to use a toilet/toilet aid with or without assistance. INTERVENTIONS Residents were randomised (1 : 1) to receive 12 30-minute sessions of transcutaneous posterior tibial nerve stimulation or sham stimulation over a 6-week period. MAIN OUTCOME MEASURES Primary outcome - change in volume of urine leaked over a 24-hour period at 6 weeks. Secondary outcomes - number of pads used, Perception of Bladder Condition, toileting skills, quality of life and resource use. RESULTS A total of 408 residents were randomised (transcutaneous posterior tibial nerve stimulation, n = 197; sham stimulation, n = 209); two exclusions occurred post randomisation. Primary outcome data were available for 345 (85%) residents (transcutaneous posterior tibial nerve stimulation, n = 167; sham stimulation, n = 178). Adherence to the intervention protocol was as follows: 78% of the transcutaneous posterior tibial nerve stimulation group and 71% of the sham group received the correct stimulation. Primary intention-to-treat adjusted analysis indicated a mean change of -5 ml (standard deviation 362 ml) urine leakage from baseline in the transcutaneous posterior tibial nerve stimulation group and -66 ml (standard deviation 394 ml) urine leakage in the sham group, which was a statistically significant, but not clinically important, between-group difference of 68-ml urine leakage (95% confidence interval 0 to 136 ml; p = 0.05) in favour of the sham group. Sensitivity analysis supported the primary analysis. No meaningful differences were detected in any of the secondary outcomes. No serious adverse events related to transcutaneous posterior tibial nerve stimulation were reported. Economic evaluation assessed the resources used. The training and support costs for the staff to deliver the intervention were estimated at £121.03 per staff member. Estimated costs for delivery of transcutaneous posterior tibial nerve stimulation during the trial were £81.20 per participant. No significant difference was found between participants' scores over time, or between transcutaneous posterior tibial nerve stimulation and sham groups at any time point, for resident or proxy quality-of-life measures. CONCLUSIONS The ELECTRIC (ELECtric Tibial nerve stimulation to Reduce Incontinence in Care homes) trial showed, in the care home context (with a high proportion of residents with poor cognitive capacity and limited independent mobility), that transcutaneous posterior tibial nerve stimulation was not effective in reducing urinary incontinence. No economic case for transcutaneous posterior tibial nerve stimulation was made by the cost-consequences analysis; however, the positive reception of learning about urinary incontinence for care home staff supports a case for routine education in this care context. LIMITATIONS Completing 24-hour pad collections was challenging for care home staff, resulting in some missing primary outcome data. FUTURE WORK Research should investigate transcutaneous posterior tibial nerve stimulation in residents with urgency urinary incontinence to determine whether or not targeted stimulation is effective. Research should evaluate the effects of continence training for staff on continence care in care homes. TRIAL REGISTRATION Current Controlled Trials ISRCTN98415244 and ClinicalTrials.gov NCT03248362. FUNDING This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 25, No. 41. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Joanne Booth
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Lorna Aucott
- Centre for Healthcare Randomised Trials (CHaRT), University of Aberdeen, Aberdeen, UK
| | - Seonaidh Cotton
- Centre for Healthcare Randomised Trials (CHaRT), University of Aberdeen, Aberdeen, UK
| | - Bridget Davis
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Linda Fenocchi
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - Claire Goodman
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
| | - Suzanne Hagen
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - Danielle Harari
- Department of Geriatric Medicine, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Maggie Lawrence
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | | | - Lisa Macaulay
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Graeme MacLennan
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Helen Mason
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - Doreen McClurg
- Nursing, Midwifery and Allied Health Professions Research Unit, Glasgow Caledonian University, Glasgow, UK
| | - John Norrie
- Usher Institute, University of Edinburgh, Edinburgh, UK
| | - Christine Norton
- Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, London, UK
| | - Catriona O'Dolan
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Dawn Skelton
- School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Claire Surr
- School of Health and Community Studies, Leeds Beckett University, Leeds, UK
| | - Shaun Treweek
- Centre for Healthcare Randomised Trials (CHaRT), University of Aberdeen, Aberdeen, UK
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18
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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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Interplay Between Cognitive and Bowel/Bladder Function in Multiple Sclerosis. Int Neurourol J 2021; 25:310-318. [PMID: 33957715 PMCID: PMC8748300 DOI: 10.5213/inj.2040346.173] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 11/29/2020] [Indexed: 11/16/2022] Open
Abstract
Purpose The aim of this study was to evaluate the prevalence of bowel/bladder dysfunction in multiple sclerosis (MS) and its associations with cognitive impairment. Methods We prospectively enrolled 150 MS patients. Patients were administered the Symbol Digit Modality Test (SDMT), the Neurogenic Bowel Dysfunction Score (NBDS), and the Actionable Bladder Symptom Screening Tool (ABSST). The associations between bowel/bladder dysfunction and cognitive function were assessed through hierarchical regression models using the SDMT and clinicodemographic features as independent variables and NBDS and ABSST scores as dependent variables. Results The prevalence of bowel/bladder deficits was 44.7%, with 26 patients (17.3%) suffering from bowel deficits and 60 patients (40%) from bladder deficits. The total NBDS and ABSST scores were correlated with the SDMT (β=-0.10, P<0.001 and β=-0.03, P=0.04, respectively) after correction for demographic features and physical disability. Conclusions Bowel/bladder disorders are common in MS and are associated with both physical and cognitive disability burdens. As SDMT is embedded into routine clinical assessments, a lower score may warrant investigating bowel/bladder dysfunction due to the strong interplay of these factors.
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Batmani S, Jalali R, Mohammadi M, Bokaee S. Prevalence and factors related to urinary incontinence in older adults women worldwide: a comprehensive systematic review and meta-analysis of observational studies. BMC Geriatr 2021; 21:212. [PMID: 33781236 PMCID: PMC8008630 DOI: 10.1186/s12877-021-02135-8] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 03/07/2021] [Indexed: 12/14/2022] Open
Abstract
Background Urinary incontinence is a common condition in the general population and, in particular, the older adults population, which reduces the quality of life of these people, so this study aims to systematically examine and meta-analyse the overall prevalence of urinary incontinence in older women around the world and the related and influential factors. Methods This report is a comprehensive systematic review and meta-analysis of the findings of research on urinary incontinence in older adults people across the world through looking for MEDLINE, Cochrane Library Sciencedirect, Embase, Scopus, ProQuest and Persian databases, namely iranmedex, magiran, and SID from January 2000 to April 2020, the heterogeneity of the experiments was measured using the I2 index and the data processing was done in the Systematic Meta-Analysis programme. Results In 29 studies and the sample size of 518,465 people in the age range of 55–106 years, urinary incontinence in older adults’ women in the world based on a meta-analysis of 37.1% (95% CI: 29.6–45.4%) was obtained. The highest prevalence of urinary incontinence was reported in older adults’ women in Asia with 45.1% (95% CI: 36.9–53.5%). Meta-regression also showed that with increasing the sample size and year of the study, the overall prevalence of urinary incontinence in the older adults women of the world decreased and increased, respectively, which were statistically significant differences (P < 0.05). According to studies, the most important factors influencing the incidence of urinary incontinence in older women are women’s age (p < 0.001), obesity (p < 0.001), diabetes (p < 0.001), women’s education (p < 0.001), delivery rank (p < 0.001), hypertension (p < 0.001), smoking (p < 0.001). They also have urinary tract infections (p < 0.001). Conclusion Given the high prevalence of urinary incontinence in older women around the world, health policy makers must consider control and diagnostic measures in older women and prioritize treatment and rehabilitation activities.
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Affiliation(s)
- Sedighe Batmani
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Rostam Jalali
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Masoud Mohammadi
- Department of Nursing, School of Nursing and Midwifery, Kermanshah University of Medical Sciences, Kermanshah, Iran.
| | - Shadi Bokaee
- Faculty of Health and Life Sciences, School of Life Sciences, Coventry University, Coventry, UK
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21
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Fedecostante M, Onder G, Eusebi P, Dell'Aquila G, Zengarini E, Carrieri B, Manes Gravina E, Falsiroli C, Corsonello A, Luzi R, Lattanzio F, Bernabei R, Cherubini A. Predictors of Functional Decline in Nursing Home Residents: The Shelter Project. J Gerontol A Biol Sci Med Sci 2021; 75:1600-1605. [PMID: 31858108 DOI: 10.1093/gerona/glz296] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2019] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND The aim of our study was to identify independent predictors of functional decline in older nursing home (NH) residents, taking into account both resident and facility characteristics. METHODS Longitudinal observational study involving 1,760 older (≥65 y) residents of NH participating in the SHELTER* study (57 NH in eight countries). All residents underwent a comprehensive geriatric assessment using the interRAI LTCF. Functional decline was defined as an increase of at least one point in the MDS Long Form ADL scale during a 1 year follow-up. Facility and country effects were taken into account. RESULTS During the study period 891 (50.6%), NH residents experienced ADL decline. Residents experiencing ADL decline were older, had lower disability at baseline, were more frequently affected by severe dementia and by urinary incontinence, and used more antipsychotics. In the mixed-effect logistic regression model, factors independently associated with a higher risk of functional decline were dementia and urinary incontinence, whereas the presence of a geriatrician was a protective factor. CONCLUSIONS Both resident and facility characteristics are associated with the risk of functional decline in NH residents. Increasing the quality of healthcare by involving a geriatrician in residents' care might be an important strategy to improve the outcome of this vulnerable population.
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Affiliation(s)
- Massimiliano Fedecostante
- Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, Ancona, Italy
| | - Graziano Onder
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Italy e Università Cattolica del Sacro Cuore, Rome, Italy
| | - Paolo Eusebi
- Health Planning Service, Regional Health Authority of Umbria, Perugia, Italy
| | - Giuseppina Dell'Aquila
- Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, Ancona, Italy
| | - Elisa Zengarini
- Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, Ancona, Italy
| | - Barbara Carrieri
- Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, Ancona, Italy.,Department of Life and Environmental Sciences, Polytechnic University of Marche, Ancona, Italy
| | - Ester Manes Gravina
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Italy e Università Cattolica del Sacro Cuore, Rome, Italy
| | - Cinzia Falsiroli
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Italy e Università Cattolica del Sacro Cuore, Rome, Italy
| | - Andrea Corsonello
- Unit of Geriatric Pharmacoepidemiology and Clinical Laboratory, IRCCS INRCA, Cosenza, Italy
| | | | | | - Roberto Bernabei
- Fondazione Policlinico Universitario A. Gemelli IRCCS, Italy e Università Cattolica del Sacro Cuore, Rome, Italy
| | - Antonio Cherubini
- Geriatria, Accettazione geriatrica e Centro di ricerca per l'invecchiamento, IRCCS INRCA, Ancona, Italy
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22
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Choi EPH, Huang J, Chau PH, Wan EYF. Health-related quality of life among Chinese primary care patients with different lower urinary tract symptoms: a latent class analysis. Qual Life Res 2021; 30:1305-1315. [PMID: 33447962 DOI: 10.1007/s11136-020-02731-y] [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: 12/02/2020] [Indexed: 12/16/2022]
Abstract
PURPOSE No previous study has used a data-driven approach to explore symptom subclasses among patients with lower urinary tract symptoms (LUTS). The objectives of this study were to use latent class analysis (LCA) to identify distinct classes of LUTS among primary care patients and to assess the class differences in health-related quality of life (HRQOL). METHODS In this cross-sectional study, 500 patients were randomly recruited, and 18 symptoms according to the International Continence Society 2002 criteria were assessed. Classes were identified by LCA. Patient HRQOL was measured using the 12-item Short Form Health Survey (version 2), the modified Incontinence Impact Questionnaire-Short Form and the HRQOL item from the International Prostate Symptom Score. RESULTS Six distinct LUTS classes were identified: "asymptomatic" (26.0%), "mild symptoms" (22.6%), "moderate multiple symptoms" (17.0%), "urgency symptoms" (13.8%), "urinary incontinence" (12.0%) and "severe multiple symptoms" (8.6%). Multinomial regression analysis found differences in the gender distribution and prevalence of heart diseases across classes, and multiple linear regression found that patients with "severe multiple symptoms" and "urinary incontinence" had the poorest HRQOL. CONCLUSION Almost three quarters of the primary care patients in this study were suffering from varying degrees of LUTS. The poor HRQOL in "severe multiple symptoms" and "urinary incontinence" implies that patients in these classes require additional attention and treatments.
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Affiliation(s)
- Edmond Pui Hang Choi
- School of Nursing, University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong.
| | - Jing Huang
- School of Nursing, University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Pui Hing Chau
- School of Nursing, University of Hong Kong, 4/F, William M.W. Mong Block, 21 Sassoon Road, Pokfulam, Hong Kong
| | - Eric Yuk Fai Wan
- Department of Family Medicine and Primary Care, University of Hong Kong, Pokfulam, Hong Kong.,Department of Pharmacology and Pharmacy, University of Hong Kong, Pokfulam, Hong Kong
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23
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Luo Y, Wang K, Zou P, Li X, He J, Wang J. Prevalence and Associated Factors of Fecal Incontinence and Double Incontinence among Rural Elderly in North China. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17239105. [PMID: 33291250 PMCID: PMC7730966 DOI: 10.3390/ijerph17239105] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/12/2020] [Revised: 11/20/2020] [Accepted: 12/03/2020] [Indexed: 12/31/2022]
Abstract
Fecal and double incontinence are known to be more prevalent among the rural elderly. Yet, there have been few studies on their epidemic condition among Chinese rural elders. This study estimated the prevalence and correlates of fecal and double incontinence in rural elderly aged 65 years and over in North China. A multisite cross-sectional survey was conducted in 10 villages, yielding a sampling frame of 1250 residents. Fecal and urinary incontinence assessments were based on the self-reported bowel health questionnaire and the International Consultation on Incontinence Questionnaire-Short Form, respectively. The concomitant presence of fecal and urinary incontinence in the same subject was defined as double incontinence. The prevalence of fecal and double incontinence was 12.3% and 9.3%, respectively. Factors associated with fecal incontinence included urinary incontinence, lack of social interaction, traumatic brain injury, cerebrovascular disease, and poverty. Physical activities of daily living dependence, traumatic brain injury, lack of social interaction, and poor sleep quality were associated with higher odds of having double incontinence, whereas tea consumption was correlated with lower odds. Individualized intervention programs should be developed targeting associated factors and high-risk populations. These intervention programs should be integrated into existing public health services for the rural elderly to facilitate appropriate prevention and management of incontinence.
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Affiliation(s)
- Yan Luo
- Faculty of Nursing, Health Science Center, Xi’an Jiaotong University, 76# Yanta West Road, Xi’an 710061, China; (Y.L.); (X.L.); (J.H.)
| | - Kai Wang
- Department of Epidemiology and Biostatistics, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, 13# Hang Kong Road, Wuhan 430030, China;
| | - Ping Zou
- School of Nursing, Nipissing University, 750 Dundas West, Room 209, Toronto, ON M6J 3S3, Canada;
| | - Xiaomei Li
- Faculty of Nursing, Health Science Center, Xi’an Jiaotong University, 76# Yanta West Road, Xi’an 710061, China; (Y.L.); (X.L.); (J.H.)
| | - Jinjie He
- Faculty of Nursing, Health Science Center, Xi’an Jiaotong University, 76# Yanta West Road, Xi’an 710061, China; (Y.L.); (X.L.); (J.H.)
| | - Jing Wang
- Faculty of Nursing, Health Science Center, Xi’an Jiaotong University, 76# Yanta West Road, Xi’an 710061, China; (Y.L.); (X.L.); (J.H.)
- Correspondence: ; Tel.: +86-29-8265-7015
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24
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Manuelyan Z, Siomara Muñiz K, Stein E. Common Urinary and Bowel Disorders in the Geriatric Population. Med Clin North Am 2020; 104:827-842. [PMID: 32773048 DOI: 10.1016/j.mcna.2020.06.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
The prevalence of urinary incontinence and other lower urinary tract symptoms increases with older age. These symptoms are more noticeable in men after the seventh decade of life and in women after menopause. Constipation and fecal incontinence are major causes of symptoms in elderly patients and can significantly impair quality of life. This article summarizes the current literature regarding the occurrence and implications of lower urinary tract and bowel symptoms in the geriatric population.
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Affiliation(s)
- Zara Manuelyan
- Department of Gastroenterology, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, 3rd Floor, A Building Johns Hopkins Bayview, Baltimore, MD 21224, USA
| | - Keila Siomara Muñiz
- Department of Gynecology and Obstetrics, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, 301 Building, Suite 3100, Baltimore, MD 21224, USA
| | - Ellen Stein
- Department of Gastroenterology, Johns Hopkins University School of Medicine, 4940 Eastern Avenue, 3rd Floor, A Building Johns Hopkins Bayview, Baltimore, MD 21224, USA.
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25
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Kim S, Jung HW, Won CW. What are the illnesses associated with frailty in community-dwelling older adults: the Korean Frailty and Aging Cohort Study. Korean J Intern Med 2020; 35:1004-1013. [PMID: 32264654 PMCID: PMC7373975 DOI: 10.3904/kjim.2019.097] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/20/2019] [Revised: 04/12/2019] [Accepted: 04/29/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND/AIMS Frailty is mainly due to an age-related decrease in the physiological reserves needed to maintain biological homeostasis, but it can also occur as a result of chronic diseases. The purpose of this study was to identify illnesses associated with frailty in Korean community-dwelling older adults. METHODS This was a cross-sectional study that included 2,936 older adults aged between 70 and 84 years who had completed both interviews and physical function assessments for the Korean Frailty and Aging Cohort Study. Current illnesses diagnosed by physicians were included in the analysis. The definition of frailty was derived from the Fried frailty phenotype. RESULTS The prevalence of hypertension, diabetes mellitus (DM), arthritis, osteoporosis, urinary incontinence, and lung disease (including asthma, chronic obstructive pulmonary disease, and chronic bronchitis) was higher in the frail group (p < 0.05). After adjusting for age, sex, physical activity, alcohol, smoking, education, and presence of a spouse, the odds ratios for DM and urinary incontinence in frailty were 1.51 (95% confidence interval [CI], 1.10 to 2.01; p = 0.01) and 1.88 (95% CI, 1.11 to 3.18; p = 0.02). CONCLUSION In Korean community-dwelling older adults, DM and urinary incontinence were associated with frailty after adjusting for various factors. In the future, the list of comorbid diseases that are appropriate for Korean population-specific frailty assessment should be inventoried.
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Affiliation(s)
- Sunyoung Kim
- Department of Family Medicine, Kyung Hee University College of Medicine, Seoul, Korea
| | - Hee-Won Jung
- Department of Internal Medicine, Seoul National University Hospital, Seoul, Korea
| | - Chang Won Won
- Elderly Frailty Research Center, Department of Family Medicine, Kyung Hee University College of Medicine, Seoul, Korea
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Su YY, Tsai YY, Chu CL, Lin CC, Chen CM. Exploring a Path Model of Cognitive Impairment, Functional Disability, and Incontinence Among Male Veteran Home Residents in Southern Taiwan. Sci Rep 2020; 10:5553. [PMID: 32221413 PMCID: PMC7101370 DOI: 10.1038/s41598-020-62477-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2019] [Accepted: 03/11/2020] [Indexed: 11/28/2022] Open
Abstract
Most studies focusing on only one directional effect among cognitive health, physical function, and incontinence may miss potential paths. This study aimed to determine the pathway by analyzing the bidirectional effects of exposure (X) on outcome (Y) and explore the mediating effect (M) between X and Y. Secondary data analyses were performed in this study. The original data were collected from August to October 2013 in one VH in Tainan, Taiwan, and the final sample size was 144 older male veterans. Path analysis was performed to test the pathway sequence X → M → Y among the three outcome variables. Approximately 80% of the veterans were aged 81 or older, approximately 42% had a functional disability, 26% had cognitive impairment, and 20% had incontinence. The relationships between functional disability and incontinence and between functional disability and cognition impairment were bidirectional, and functional disability played a key mediating role in the relationship between cognitive impairment and incontinence. Physical more than cognitive training in order to improve or at least stabilize functional performance could be a way to prevent or reduce the process of developing incontinence.
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Affiliation(s)
- Yung-Yu Su
- Department of Long-Term Care, National Quemoy University, No. 1, University Rd., Jinning Township, Kinmen County, 892, Taiwan (R.O.C.)
| | - Ying-Yi Tsai
- Kaohsiung Veterans General Hospital Pingtung Branch, No.1. Anping Lane 1. Jausheng Rd., Nei Pu Township, Ping-Tung County, 912, Taiwan (R.O.C.)
| | - Chiao-Lee Chu
- Department of Long-Term Care, National Quemoy University, No. 1, University Rd., Jinning Township, Kinmen County, 892, Taiwan (R.O.C.)
| | - Chien-Chih Lin
- Department of Nursing, Meiho University, No. 23 Ping Kuang Rd., Nei Pu Township, Ping-Tung County, 912, Taiwan (R.O.C.)
| | - Chun-Min Chen
- Research Education and Epidemiology Center, Changhua Christian Hospital, No.135 Nan-Hsiao Street, Changhua, 500-06, Taiwan (R.O.C.).
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Tkaczynska Z, Becker S, Maetzler W, Timmers M, Van Nueten L, Sulzer P, Salvadore G, Schäffer E, Brockmann K, Streffer J, Berg D, Liepelt-Scarfone I. Executive Function Is Related to the Urinary Urgency in Non-demented Patients With Parkinson's Disease. Front Aging Neurosci 2020; 12:55. [PMID: 32210789 PMCID: PMC7069351 DOI: 10.3389/fnagi.2020.00055] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Accepted: 02/18/2020] [Indexed: 12/16/2022] Open
Abstract
Introduction: Evidence suggests urinary urgency is associated with cognitive impairment in a subtype of Parkinson’s disease (PD) patients. This study investigates if cognitive impairment independently predicts the presence of urinary dysfunction. Methods: We report data of 189 idiopathic PD patients, excluding those with concomitant diseases or medication interacting with bladder function. A standardized questionnaire was used to define the presence of urinary urgency. All patients underwent a comprehensive motor, cognitive non-motor and health-related quality of life (HRQoL) assessment. Multivariable linear regression analysis was performed to identify independent variables characterizing urinary urgency in PD (PD-UU), which were assigned as discriminant features to estimate their individual contribution to the phenotype of the PD-UU group. Results: Of 189 PD patients, 115 (60.8%) reported PD-UU. The linear regression analysis showed that among cognitive domains, executive function (EF; p = 0.04) had a significant negative association with PD-UU. In a second model, scores of the Montreal Cognitive Assessment (MoCA) significantly differentiated between study groups (p = 0.007) and also non-motor symptom (NMS) burden (p < 0.001). The third model consisted of reports of HRQoL, of which stigma was the only subscale of the Parkinson’s Disease Questionnaire (PDQ-39) differentiating between patients with and without PD-UU (p = 0.02). The linear discriminant analysis provided evidence that the combination of EF, NMS burden, nocturia, and stigma discriminated between groups with 72.4% accuracy. Conclusion: In our large, non-demented PD cohort, urinary urgency was associated with executive dysfunction (EF), supporting a possible causative link between both symptoms. A combination of neuropsychological and non-motor aspects identified patients with PD-UU with high discriminative accuracy.
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Affiliation(s)
- Zuzanna Tkaczynska
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Sara Becker
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Walter Maetzler
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,Department of Neurology, Christian-Albrechts-University, Kiel, Germany
| | - Maarten Timmers
- Janssen Research and Development, Janssen-Pharmaceutical Companies of Johnson & Johnson, Beerse, Belgium.,Reference Center for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Luc Van Nueten
- Janssen Research and Development, Janssen-Pharmaceutical Companies of Johnson & Johnson, Beerse, Belgium
| | - Patricia Sulzer
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Giacomo Salvadore
- Janssen Research and Development LLC, Janssen-Pharmaceutical Companies of Johnson & Johnson, Titusville, NJ, United States
| | - Eva Schäffer
- Department of Neurology, Christian-Albrechts-University, Kiel, Germany
| | - Kathrin Brockmann
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
| | - Johannes Streffer
- Janssen Research and Development, Janssen-Pharmaceutical Companies of Johnson & Johnson, Beerse, Belgium.,Reference Center for Biological Markers of Dementia (BIODEM), Institute Born-Bunge, University of Antwerp, Antwerp, Belgium
| | - Daniela Berg
- German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany.,Department of Neurology, Christian-Albrechts-University, Kiel, Germany
| | - Inga Liepelt-Scarfone
- Department of Neurodegenerative Diseases, Hertie Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany.,German Center for Neurodegenerative Diseases (DZNE), University of Tübingen, Tübingen, Germany
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28
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Booth J, Aucott L, Cotton S, Goodman C, Hagen S, Harari D, Lawrence M, Lowndes A, Macaulay L, MacLennan G, Mason H, McClurg D, Norrie J, Norton C, O’Dolan C, Skelton DA, Surr C, Treweek S. ELECtric Tibial nerve stimulation to Reduce Incontinence in Care homes: protocol for the ELECTRIC randomised trial. Trials 2019; 20:723. [PMID: 31843002 PMCID: PMC6915984 DOI: 10.1186/s13063-019-3723-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2019] [Accepted: 09/13/2019] [Indexed: 01/24/2023] Open
Abstract
BACKGROUND Urinary incontinence (UI) is highly prevalent in nursing and residential care homes (CHs) and profoundly impacts on residents' dignity and quality of life. CHs predominantly use absorbent pads to contain UI rather than actively treat the condition. Transcutaneous posterior tibial nerve stimulation (TPTNS) is a non-invasive, safe and low-cost intervention with demonstrated effectiveness for reducing UI in adults. However, the effectiveness of TPTNS to treat UI in older adults living in CHs is not known. The ELECTRIC trial aims to establish if a programme of TPTNS is a clinically effective treatment for UI in CH residents and investigate the associated costs and consequences. METHODS This is a pragmatic, multicentre, placebo-controlled, randomised parallel-group trial comparing the effectiveness of TPTNS (target n = 250) with sham stimulation (target n = 250) in reducing volume of UI in CH residents. CH residents (men and women) with self- or staff-reported UI of more than once per week are eligible to take part, including those with cognitive impairment. Outcomes will be measured at 6, 12 and 18 weeks post randomisation using the following measures: 24-h Pad Weight Tests, post void residual urine (bladder scans), Patient Perception of Bladder Condition, Minnesota Toileting Skills Questionnaire and Dementia Quality of Life. Economic evaluation based on a bespoke Resource Use Questionnaire will assess the costs of providing a programme of TPTNS. A concurrent process evaluation will investigate fidelity to the intervention and influencing factors, and qualitative interviews will explore the experiences of TPTNS from the perspective of CH residents, family members, CH staff and managers. DISCUSSION TPTNS is a non-invasive intervention that has demonstrated effectiveness in reducing UI in adults. The ELECTRIC trial will involve CH staff delivering TPTNS to residents and establish whether TPTNS is more effective than sham stimulation for reducing the volume of UI in CH residents. Should TPTNS be shown to be an effective and acceptable treatment for UI in older adults in CHs, it will provide a safe, low-cost and dignified alternative to the current standard approach of containment and medication. TRIAL REGISTRATION ClinicalTrials.gov, NCT03248362. Registered on 14 August 2017. ISRCTN, ISRCTN98415244. Registered on 25 April 2018. https://www.isrctn.com/.
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Affiliation(s)
- J. Booth
- School of Health and Life Sciences, Glasgow Caledonian University, Govan Mbeki Building, Glasgow, G4 0BA UK
| | - L. Aucott
- Centre for Healthcare Randomised Trials (CHaRT), University of Aberdeen, Aberdeen, UK
| | - S. Cotton
- Centre for Healthcare Randomised Trials (CHaRT), University of Aberdeen, Aberdeen, UK
| | - C. Goodman
- Centre for Research in Primary and Community Care, University of Hertfordshire, Hatfield, UK
| | - S. Hagen
- Nursing, Midwifery and Allied Health Professions Research Unit (NMAHP RU), Glasgow Caledonian University, Glasgow, UK
| | - D. Harari
- Guy’s and St Thomas’ NHS Foundation Trust, London, UK
| | - M. Lawrence
- School of Health and Life Sciences, Glasgow Caledonian University, Govan Mbeki Building, Glasgow, G4 0BA UK
| | - A. Lowndes
- Playlist for Life, Unit 1/14, Govanhill Workspace, Glasgow,, UK
| | - L. Macaulay
- School of Health and Life Sciences, Glasgow Caledonian University, Govan Mbeki Building, Glasgow, G4 0BA UK
| | - G. MacLennan
- Health Services Research Unit, University of Aberdeen, Aberdeen, UK
| | - H. Mason
- Yunus Centre for Social Business and Health, Glasgow Caledonian University, Glasgow, UK
| | - D. McClurg
- Nursing, Midwifery and Allied Health Professions Research Unit (NMAHP RU), Glasgow Caledonian University, Glasgow, UK
| | - J. Norrie
- Usher Institute, Edinburgh University, Edinburgh, UK
| | | | - C. O’Dolan
- School of Health and Life Sciences, Glasgow Caledonian University, Govan Mbeki Building, Glasgow, G4 0BA UK
| | - D. A. Skelton
- School of Health and Life Sciences, Glasgow Caledonian University, Govan Mbeki Building, Glasgow, G4 0BA UK
| | - C. Surr
- School of Health and Community Studies, Leeds Beckett University, Leeds, UK
| | - S. Treweek
- Centre for Healthcare Randomised Trials (CHaRT), University of Aberdeen, Aberdeen, UK
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Li HC, Chen KM, Hsu HF. Modelling factors of urinary incontinence in institutional older adults with dementia. J Clin Nurs 2019; 28:4504-4512. [PMID: 31429131 DOI: 10.1111/jocn.15039] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 07/04/2019] [Accepted: 08/03/2019] [Indexed: 12/15/2022]
Abstract
AIMS AND OBJECTIVES This study applied structural equation modelling to explore the relationships among agitated behaviours, depression, cognitive function and activities of daily living, as well as associations between these factors and urinary incontinence). BACKGROUND A high prevalence of urinary incontinence is found among institutional older adults with dementia. People with urinary incontinence suffer from increased financial burden and social isolation and experience reduced quality of life. DESIGN Cross-sectional correlational research. The study complied with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement. METHODS In total, 226 older adults with dementia were recruited through convenience sampling at 15 long-term care facilities in southern Taiwan. The urinary incontinence frequency, agitated behaviours, depression, cognitive function and activities of daily living were evaluated using bladder records, the Cohen-Mansfield Agitation Inventory, the Cornell Scale for Depression in Dementia, the Mini-Mental State Examination and the Barthel Index, respectively. RESULTS Activities of daily living performance was found to be significantly associated with urinary incontinence; however, age, cognitive function, depression and agitated behaviours were not significantly related to urinary incontinence. Age did not have effects on any of the variables tested in this model, whereas activities of daily living performance was significantly associated with cognitive function and depression. Results further showed that cognitive function and depression were mediators between activities of daily living and agitated behaviours. CONCLUSION Enhanced activities of daily living independency directly reduced urinary incontinence, improved cognitive function, decreased degrees of depression and indirectly reduced agitated behaviours. RELEVANCE TO CLINICAL PRACTICE The findings could serve as a valuable reference for long-term care facilities in providing effective urinary incontinence care and prevention to older adults with dementia.
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Affiliation(s)
- Hui-Chi Li
- Department of Nursing, I-Shou University, Kaohsiung, Taiwan
| | - Kuei-Min Chen
- College of Nursing, Kaohsiung Medical University, Kaohsiung, Taiwan.,Department of Medical Research, Kaohsiung Medical University Hospital, Kaohsiung, Taiwan
| | - Hui-Fen Hsu
- Center for Long-Term Care Research, Kaohsiung Medical University, Kaohsiung, Taiwan
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30
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Dantas TH, Castaneda L, Correia GN, Campelo CLDC, Sousa Dantas D. Functioning and disability of premenopausal women with urinary incontinence: An assessment by using the World Health Organization Disability Assessment Schedule—WHODAS 2.0. Neurourol Urodyn 2019; 38:1767-1774. [DOI: 10.1002/nau.24073] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2018] [Revised: 05/19/2019] [Accepted: 05/27/2019] [Indexed: 12/17/2022]
Affiliation(s)
- Thaissa Hamana Dantas
- Postgraduate Program of Rehabilitation Sciences, Faculty of Health Sciences of TrairiFederal University of Rio Grande do NorteNatal Brazil
| | - Luciana Castaneda
- Federal Institute of EducationScience and Technology of Rio de JaneiroNiterói Brazil
| | - Grasiéla Nascimento Correia
- Postgraduate Program of Rehabilitation Sciences, Faculty of Health Sciences of TrairiFederal University of Rio Grande do NorteNatal Brazil
| | | | - Diego Sousa Dantas
- Postgraduate Program of Rehabilitation Sciences, Faculty of Health Sciences of TrairiFederal University of Rio Grande do NorteNatal Brazil
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Borges CL, Fernandes BKC, Cavalcante MLSN, Barbosa RGB, Peixoto Junior AA, Menezes LCGD. Fatores de risco para incontinência urinária em idosos institucionalizados. ESTIMA 2019. [DOI: 10.30886/estima.v16.726_pt] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objetivo: Analisar os fatores de risco para incontinência urinária (IU) em idosos institucionalizados. Métodos: Estudo transversal, analítico, documental realizado por coleta em 203 prontuários de uma instituição de longa permanência no nordeste do Brasil. Foram utilizados um instrumento para caracterização sociodemográfica e de saúde e os valores do Mini Exame do Estado Mental (MEEM). Os dados foram analisados a partir da estatística descritiva, inferencial e por regressão logística múltipla. Resultados: A prevalência de IU foi de 42,36% e maior em mulheres (66,28%), mais velhos (média: 79,62 anos) e dependentes (89,53%). Houve associação entre idade (p = 0,01), sexo (p = 0,024), estado civil (p = 0,007), religião (p = 0,015), com quem residia antes da institucionalização (p = 0,033), grau de dependência (p < 0,001), valores do MEEM (p < 0,001) e doenças cardiovasculares (p < 0,001) e neurológicas (p < 0,001). Os fatores de risco para IU foram quantidade de doenças [odds ratio (OR) = 1,17; intervalo de confiança de 95% (IC95%) = 1,02-1,34], consumo de cinco a nove medicamentos (OR = 4,07; IC95% = 1,14-14,52), ser solteiro (OR = 2,09; IC95% = 1,30-8,01), dependente (OR = 3,27; IC95% = 1,33-8,04) e ter baixa pontuação no MEEM (OR = 0,88; IC95% = 0,85-0,93). Conclusão: Os resultados revelam a importância de estudar IU nessa população para identificar precocemente os fatores de risco passíveis de prevenção.
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Borges CL, Fernandes BKC, Cavalcante MLSN, Barbosa RGB, Peixoto Junior AA, Menezes LCGD. Risk factors for urinary incontinence in institutionalized elderly. ESTIMA 2019. [DOI: 10.30886/estima.v16.726_in] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
Objectives: To analyze the risk factors for urinary incontinence (UI) in institutionalized elderly. Methods: Cross-sectional, analytical, documentary study done by collection in 203 medical records of a long-stay institution in northeastern Brazil. An instrument for sociodemographic and health characterization and the values of the Mini Mental State Examination (MMSE) were used. The data were analyzed from the descriptive, inferential and multiple logistic regression. Results: The prevalence of UI was 42.36% and higher in women (66.28%), older (mean: 79.62 years) and dependent (89.53%). There was an association between age (p = 0.01), sex (p = 0.024), marital status (p = 0.007), religion (p = 0.015), with whom resided before institutionalization (p = 0.033), degree of dependency (p < 0.001), MMSE values (p < 0.001) and cardiovascular (p < 0.001) and neurological diseases (p < 0,001). The risk factors for UI were number of diseases (OR = 1.17; 95%CI = 1.02-1.34), consumption of five to nine medications (OR = 4.07, 95% CI = 1.14-14.52), single (OR = 2.09, 95% CI = 1.30-8.01),dependent (OR = 3.27, 95% CI = 1.33-8.04) and had a low MMSE score (OR = 0.88, 95% CI= 0.85-0.93). Conclusion: The results reveal the importance of studying UI in this population to identify early risk factors that can be prevented.
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Wagg A. Continence in nursing homes: a state of irreversible decline? Nat Rev Urol 2019; 16:278-279. [PMID: 30872816 DOI: 10.1038/s41585-019-0172-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Adrian Wagg
- Department of Medicine, University of Alberta, Alberta, Canada. .,Gothenburg Continence Research Centre, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden.
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Bamoudou N, Desvergee A, Leroy F, Parienti JJ, Ruet A. [Lower Urinary Tract Dysfunction (LUTD) in institutionalized handicapped adults]. Prog Urol 2019; 29:235-245. [PMID: 30685407 DOI: 10.1016/j.purol.2018.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2018] [Revised: 12/20/2018] [Accepted: 12/21/2018] [Indexed: 11/18/2022]
Abstract
OBJECTIVES To assess the prevalence and the management of the lower urinary tract dysfunction (LUTD) in institutionalized handicapped adults. MATERIALS AND METHODS Descriptive transversal observational study. Epidemiological study. RESULTS In this study realized in 150 residents of 6 nursing homes for adult, the prevalence of LUTD in institutionalized handicapped adults was 88.67% (133/150). This prevalence was 91.36% (74/81) for women versus 85.51% (59/69) for men, (P=0.260); 93.33% (14/15) in medical housing units [foyer d'accueil médicalisé (FAM)] versus 88.15% (119/135) in specialized housing units [maison d'accueil spécialisé (MAS)], (P=1); 80% (52/65) for those who walked without technical support, 89.47% (17/19) for those who walked with technical support, 98.08% (51/52) for the wheelchair users who were not able to walk, and 92.86% (13/14) for those who were not able to walk or to use wheelchair, (P=0.004); 69.81% (37/53) for those who were able to signal the need to void versus 98.97% (96/97) for those who were not able, (P=0.0000003); 76.92% (50/60) for those who were able to realize the transfers independently, versus 97.65% (83/85) for those who were not able, (P=0.0002); 67.39% (31/46) for those who could dress and undress by themselves versus 98.08% (102/104) for those who could not, (P=0.0000002); 77.27% (17/22) for water intake>2L, 91.67% (55/60) between 1.5 and 2L, 87.5% (49/56) between 1 and 1.5L, and 100% (12/12) for water intake<1L, (P=0.170). The LUTD were more frequent in people with physical disability (OR=10.70[1.53-75.09], P=0.017), in those with mental disability (OR=5.85[1.39-24.67], P=0.016), and in those with urological comorbidity (OR=9.70[1.25-75.55], P=0.03). For the management of the LUTD, the prevalence of expert medical advice was 9.77%, 24.81% (33/133) for the further examination, 16.54% (22/133) for rehabilitation treatment, 6.77% (9/133) for drug treatment, 2.26% (3/133) for surgical treatment, and 82.71% (110/133) for medical device. CONCLUSION In this study, the prevalence of LUTD in institutionalized handicapped adults was 88.67%. LEVEL OF EVIDENCE 4.
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Affiliation(s)
- N Bamoudou
- Service de médecine physique et de réadaptation (MPR), centre hospitalier universitaire de Caen, avenue de la Côte-de-Nacre, 14033 Caen, France.
| | - A Desvergee
- Service de médecine physique et de réadaptation (MPR), centre hospitalier universitaire de Caen, avenue de la Côte-de-Nacre, 14033 Caen, France.
| | - F Leroy
- Service de médecine physique et de réadaptation (MPR), centre hospitalier universitaire de Caen, avenue de la Côte-de-Nacre, 14033 Caen, France; Réseau et service pour une vie autonome (RSVA) Normandie, 2, rue Jean-Perrin, campus Effiscience, bâtiment Innovaparc, 14460 Colombelles, France.
| | - J-J Parienti
- Unité biostatistique et recherche clinique (UBRC), centre hospitalier universitaire de Caen, avenue de la Côte-de-Nacre, 14033 Caen, France.
| | - A Ruet
- Service de médecine physique et de réadaptation (MPR), centre hospitalier universitaire de Caen, avenue de la Côte-de-Nacre, 14033 Caen, France.
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Klee NS, McCarthy CG, Lewis S, McKenzie JL, Vincent JE, Webb RC. Urothelial Senescence in the Pathophysiology of Diabetic Bladder Dysfunction-A Novel Hypothesis. Front Surg 2018; 5:72. [PMID: 30564582 PMCID: PMC6288180 DOI: 10.3389/fsurg.2018.00072] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2018] [Accepted: 11/12/2018] [Indexed: 12/11/2022] Open
Abstract
Diabetic bladder dysfunction (DBD) is a well-recognized and common symptom affecting up to 50% of all diabetic patients. DBD has a broad range of clinical presentations ranging from overactive to underactive bladder symptoms that develops in middle-aged to elderly patients with long standing and poorly controlled diabetes. Low efficacy of current therapeutics and lifestyle interventions combined with high national healthcare costs highlight the need for more research into bladder dysfunction pathophysiology and novel treatment options. Cellular senescence is an age-related physiologic process in which cells undergo irreversible growth arrest induced by replicative exhaustion and damaging insults. While controlled senescence negatively regulates cell proliferation and promotes tissue regeneration, uncontrolled senescence is known to result in tissue dysfunction through enhanced secretion of inflammatory factors. This review presents previous scientific findings and current hypotheses that characterize diabetic bladder dysfunction. Further, we propose the novel hypothesis that cellular senescence within the urothelial layer of the bladder contributes to the pro-inflammatory/pro-oxidant environment and symptoms of diabetic bladder dysfunction. Our results show increased cellular senescence in the urothelial layer of the bladder; however, whether this phenomenon is the cause or effect of DBD is unknown. The urothelial layer of the bladder is made up of transitional epithelia specialized to contract and expand with demand and plays an active role in transmission by modulating afferent activity. Transition from normal functioning urothelial cells to secretory senescence cells would not only disrupt the barrier function of this layer but may result in altered signaling and sensation of bladder fullness; dysfunction of this layer is known to result in symptoms of frequency and urgency. Future DBD therapeutics may benefit from targeting and preventing early transition of urothelial cells to senescent cells.
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Affiliation(s)
- Nicole S Klee
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Cameron G McCarthy
- Department of Physiology and Pharmacology, University of Toledo College of Medicine and Life Sciences, Toledo, OH, United States
| | - Steven Lewis
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Jaine L McKenzie
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, United States.,Department of Surgery, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - Julie E Vincent
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, United States
| | - R Clinton Webb
- Department of Physiology, Medical College of Georgia at Augusta University, Augusta, GA, United States
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Chong E, Chan M, Lim WS, Ding YY. Response to the Letter to the Editor: Flaws Related to the Article Entitled “Frailty Predicts Incident Urinary Incontinence Among Hospitalized Older Adults”. J Am Med Dir Assoc 2018; 19:1020-1021. [DOI: 10.1016/j.jamda.2018.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Accepted: 07/02/2018] [Indexed: 11/16/2022]
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Kessler M, Facchini LA, Soares MU, Nunes BP, França SM, Thumé E. Prevalence of urinary incontinence among the elderly and relationship with physical and mental health indicators. REVISTA BRASILEIRA DE GERIATRIA E GERONTOLOGIA 2018. [DOI: 10.1590/1981-22562018021.180015] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Abstract Objective: to verify the prevalence of urinary incontinence and its relationship with physical and mental health indicators in the elderly population of Bagé, Rio Grande do Sul, Brazil. Method: a cross-sectional population-based study was conducted in 2008 with 1,593 elderly persons. Poisson regression was used for crude and adjusted analysis between the outcomes and the independent variables. Results: the prevalence of urinary incontinence was 20.7%, being 26.9% among women and 10.3% among men. The associated factors were female gender, age 70 to 74 and 75 years or over, yellow/brown/indigenous ethnicity/skin color and no schooling. The prevalence of functional disability, depression, cognitive deficit and very poor/poor self-perception of health was significantly higher in women with urinary incontinence. Among incontinent men, the same was observed with regard to functional disability and cognitive deficit. Conclusion: the occurrence of urinary incontinence in the elderly is frequent, especially in women, with a significant relationship with physical and mental health conditions in the elderly population. These results support the development of care strategies to prevent incontinence and minimize its health impacts.
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