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Talebi E, Nobahar M, Foroughan M, Asgari MR. The inhibiting factors of adaptation to urinary incontinence in community-dwelling older adult women: A qualitative study. Geriatr Nurs 2024; 59:121-130. [PMID: 38996769 DOI: 10.1016/j.gerinurse.2024.06.046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/21/2024] [Revised: 06/10/2024] [Accepted: 06/27/2024] [Indexed: 07/14/2024]
Abstract
Urinary incontinence affects the physical, psychological, social and well-being of older adult women and requires adaptation. This study aimed to explain the inhibiting factors of adaptation to urinary incontinence in community-dwelling older adult women. A qualitative content analysis approach was adopted. Participants were 15 older women with urinary incontinence, three family members, and three healthcare team members. Data were collected by individual, in-depth semistructured interviews and analysed using the Graneheim and Lundman approach. The data analysis yielded the theme of neglecting urinary incontinence and the older adult, with four categories of "s silence-inducing beliefs", "worthlessness for the family", "non-adaptation of urban spaces", and "deficiencies in the healthcare service structure". Elucidating the inhibiting factors for older women's adaptation to urinary incontinence will lead to a change in the attitude of social policymakers and healthcare officials. This changes will then facilitate the establishment and adjustment of the necessary infrastructure to overcome these barriers.
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Affiliation(s)
- Elnaz Talebi
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
| | - Monir Nobahar
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran; Department of Nursing, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran.
| | - Mahshid Foroughan
- Iranian Research Center on Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Reza Asgari
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, Iran; Department of Nursing, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran
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Talebi E, Nobahar M, Foroughan M, Asgari MR. The Concerns of Community-Dwelling Older Women Living with Urinary Incontinence: Qualitative Research. Int Urogynecol J 2024; 35:1235-1244. [PMID: 38739289 DOI: 10.1007/s00192-024-05810-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Accepted: 04/12/2024] [Indexed: 05/14/2024]
Abstract
INTRODUCTION AND HYPOTHESIS The world including Iran is facing population aging. Urinary incontinence (UI) is one of the most common health concerns of older women that can be accompanied by an increased sense of loneliness, social restrictions, and disruption in activities of daily living in addition to the regular challenges of old age. This study was aimed at explaining the concerns of community-dwelling older women living with UI. METHODS This study used the conventional, qualitative, content analysis approach with purposive sampling. Twenty interviews were conducted with 18 participants, including 15 community-dwelling older women with UI and three family members (a husband and two daughters), over the span of 14 months (from August 2021 to October 2022). The data were collected via semi-structured, face-to-face interviews until data saturation was achieved, and were analyzed using Graneheim and Lundman's method. RESULTS The findings revealed that the concerns of older women with UI include the impasse of UI, being powerless in life, distorted social identity, and marital frustration, which fell under the main theme of sense of inadequacy. CONCLUSIONS Recognizing the concerns of older women with UI can make health care teams more sensitive to the importance of resolving these concerns and can offer some insight into how best to provide targeted training, support, and counseling services at individual, family, and society levels, to eventually resolve the older adult's sense of inadequacy.
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Affiliation(s)
- Elnaz Talebi
- Student Research Committee, Semnan University of Medical Sciences, Semnan, Iran
| | - Monir Nobahar
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, 3513138111, Iran.
- Department of Nursing, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran.
| | - Mahshid Foroughan
- Iranian Research Center On Aging, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Mohammad Reza Asgari
- Nursing Care Research Center, Semnan University of Medical Sciences, Semnan, 3513138111, Iran
- Department of Nursing, Faculty of Nursing and Midwifery, Semnan University of Medical Sciences, Semnan, Iran
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Wang Q, Jiang XX, Que YZ, Wan XY, Lin CQ. Development and Validation of a Risk Prediction Model for Female Stress Urinary Incontinence in Rural Fujian, China. Risk Manag Healthc Policy 2024; 17:1101-1112. [PMID: 38707519 PMCID: PMC11069356 DOI: 10.2147/rmhp.s457332] [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: 12/30/2023] [Accepted: 04/19/2024] [Indexed: 05/07/2024] Open
Abstract
Purpose With China's rapidly aging population and the rising proportion of obese people, an increase in the number of women suffering from urinary incontinence (UI) is to be expected. In order to identify high-risk groups before leakage occurs, we aimed to develop and validate a model to predict the risk of stress UI (SUI) in rural women. Patients and methods This study included women aged 20-70 years in rural Fujian who participated in an epidemiologic survey of female UI conducted between June and October 2022. Subsequently the data was randomly divided into training and validation sets in a ratio of 7:3. Univariate and multivariate logistic regression analyses were used to identify independent risk factors as well as to further construct a nomogram for risk prediction. Finally, concordance index (C-index), calibration curve and decision curve analysis were applied to evaluate the performance of the predictive models. Results A total of 5290 rural females were enrolled, of whom 771 (14.6%) had SUI. Age, body mass index (BMI), postmenopausal status, number of vaginal deliveries, vaginal delivery of large infant, constipation and family history of pelvic organ prolapse (POP) and SUI were included in the nomogram. C-index of this prediction model for the training and validation sets was 0.835 (95% confidence interval [CI] = 0.818-0.851) and 0.829 (95% CI = 0.796-0.858), respectively, and the calibration curves and decision analysis curves for both the training and validation sets showed that the model was well-calibrated and had a positive net benefit. Conclusion This model accurately estimated the SUI risk of rural women in Fujian, which may serve as an effective primary screening tool for the early identification of SUI risk and provide a basis for further implementation of individualized early intervention. Moreover, the model is concise and intuitive, which makes it more operational for rural women with scarce medical resources.
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Affiliation(s)
- Qi Wang
- Department of Gynecology, Fujian Maternity and Child Health Hospital, Fujian Provincial Key Laboratory of Women and Children’s Critical Diseases Research, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Xiao-Xiang Jiang
- Department of Gynecology, Fujian Maternity and Child Health Hospital, Fujian Provincial Key Laboratory of Women and Children’s Critical Diseases Research, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China
| | - Yan-Zhen Que
- Department of Gynecology and Obstetrics, Shaxian General Hospital, Sanming, People’s Republic of China
| | - Xiao-Ying Wan
- Department of Gynecology and Obstetrics, Shaxian General Hospital, Sanming, People’s Republic of China
| | - Chao-Qin Lin
- Department of Gynecology, Fujian Maternity and Child Health Hospital, Fujian Provincial Key Laboratory of Women and Children’s Critical Diseases Research, College of Clinical Medicine for Obstetrics & Gynecology and Pediatrics, Fujian Medical University, Fuzhou, People’s Republic of China
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Trapani S, Villa G, Poliani A, Gnecchi S, Rosa D, Manara DF. Non-Pharmacological Management of Urge Urinary Incontinence in Women between 40 and 65 Years Old: A Systematic Review. NURSING REPORTS 2024; 14:174-196. [PMID: 38251193 PMCID: PMC10801617 DOI: 10.3390/nursrep14010015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2023] [Revised: 01/03/2024] [Accepted: 01/06/2024] [Indexed: 01/23/2024] Open
Abstract
BACKGROUND Urinary incontinence (UI) has been identified as a World Health Organization health priority. In particular, urge UI (UUI) refers to urine leakage associated with a sudden and compelling desire to void urine. It affects quality of life more than other kinds of UI, but it is not always treated adequately. For these reasons, this study aimed to evaluate the effectiveness of conservative treatment practices to counteract UUI in women aged 40-65 years old. METHODS This systematic review was conducted following the Joanna Briggs Institute (JBI) methodology. According to the protocol registered in PROSPERO, a systematic search was carried out in the CINAHL, Embase, PubMed, PsycInfo, Scopus and Web of Science databases up to October 2022, to find primary studies meeting the inclusion criteria. RESULTS Fourteen studies were included. The scientific literature reported different strategies dealing with the problem of UUI, some purely physical, others physical and psycho-educational and others exclusively psychological. CONCLUSION Conservative treatments are useful to aid the reduction in UUI episodes in middle-aged women. However, none of them can be considered more effective than others due to the impossibility of conducting meta-analytical analyses. Further studies comparing the effectiveness of conservative treatments for UUI are needed.
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Affiliation(s)
- Sara Trapani
- Department of Obstetrics and Gynecology, IRCCS San Raffaele Hospital, 20132 Milan, Italy;
- Department of Biomedicine and Prevention, University of Rome Tor Vergata, 00133 Rome, Italy
| | - Giulia Villa
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.P.); (D.R.); (D.F.M.)
| | - Andrea Poliani
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.P.); (D.R.); (D.F.M.)
| | - Silvia Gnecchi
- Department of Onco-Hematology, IRCCS San Raffaele Hospital, 20132 Milan, Italy;
| | - Debora Rosa
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.P.); (D.R.); (D.F.M.)
| | - Duilio F. Manara
- Center for Nursing Research and Innovation, Vita-Salute San Raffaele University, 20132 Milan, Italy; (A.P.); (D.R.); (D.F.M.)
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Phelps C, Chess-Williams R, Moro C. The role of intracellular calcium and Rho kinase pathways in G protein-coupled receptor-mediated contractions of urinary bladder urothelium and lamina propria. Am J Physiol Cell Physiol 2023; 324:C787-C797. [PMID: 36689673 PMCID: PMC10027080 DOI: 10.1152/ajpcell.00441.2022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
The influence of extracellular and intracellular calcium on smooth muscle contractile activity varies between organs. In response to G protein-coupled receptor (GPCR) stimulation, the urinary bladder detrusor muscle has shown a 70% dependence on extracellular calcium, whereas the urothelium and lamina propria (U&LP) has a 20%-50% dependence. However, as this only accounts for partial contractile activity, the contribution of intracellular calcium and calcium sensitization pathways remains unclear. This study assessed the role of intracellular signaling pathways on GPCR-mediated urinary bladder U&LP contraction. Porcine U&LP responses to activation of the Gq/11-coupled muscarinic, histamine, 5-hydroxytryptamine (serotonin), neurokinin, prostaglandin, and angiotensin II receptors were assessed with three selective inhibitors of store-released intracellular calcium, 2-aminoethyl diphenylborinate (2-APB), cyclopiazonic acid (CPA), and ruthenium red, and three Rho kinase inhibitors, fasudil, Y-27632, and GSK269962. There was no discernible impact on receptor agonist-induced contractions of the U&LP after blocking intracellular calcium pathways, suggesting that this tissue is more sensitive to alterations in the availability of extracellular calcium. However, an alternative mechanism of action for GPCR-mediated contraction was identified to be the activation of Rho kinase, such as when Y-27632 significantly reduced the GPCR-mediated contractile activity of the U&LP by approximately 50% (P < 0.05, n = 8). This suggests that contractile responses of the bladder U&LP do not involve a significant release of calcium from intracellular stores, but that Gq/11-coupled receptor activation causes calcium sensitization via Rho kinase. This study highlights a key role for Rho kinase in the urinary bladder, which may provide a novel target in the future pharmaceutical management of bladder contractile disorders.
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Affiliation(s)
- Charlotte Phelps
- Centre for Urology Research, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Russ Chess-Williams
- Centre for Urology Research, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
| | - Christian Moro
- Centre for Urology Research, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Queensland, Australia
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Kocak Z, Bayir B, Goksoy I, Taskapu HH. The effect of perceived social support levels on coping methods for urinary incontinence in elderly men. REVISTA DA ASSOCIACAO MEDICA BRASILEIRA (1992) 2023; 69:452-457. [PMID: 36921201 PMCID: PMC10004299 DOI: 10.1590/1806-9282.20221395] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/18/2022] [Accepted: 12/08/2022] [Indexed: 03/12/2023]
Abstract
OBJECTIVE This study aimed to determine the effect of the perceived social support level on coping methods for urinary incontinence among men aged 65 years and over with urinary incontinence. METHODS A total of 92 male patients over the age of 65 years with urinary incontinence and adequate cognitive levels were included in the study. The coping methods, the environmental support, and the Multidimensional Scale of Perceived Social Support were used to collect data. RESULTS The most common method of coping was changing clothes (64 [69.6%]). The Multidimensional Scale of Perceived Social Support total mean score was 55.83±14.8, which was considered above the medium-level support. The perception level of social support caused significant differences in coping methods in individuals with urinary incontinence. CONCLUSION The view that urinary incontinence is a problem related to aging is regarded as an obstacle to seeking healthcare. Society should be made aware that urinary incontinence is not a normal condition related to aging and that it is not an insoluble problem that the elderly must endure.
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Affiliation(s)
- Zehra Kocak
- Karatay Ticaret Odası Karatay Üniversitesi, High School of Health Sciences, Department of Nursing - Konya, Turkey
| | - Berna Bayir
- Karatay Ticaret Odası Karatay Üniversitesi, High School of Health Sciences, Department of Nursing - Konya, Turkey
| | - Ibrahim Goksoy
- Necmettin Erbakan Üniversitesi, Meram Faculty of Medicine, Department of Urology - Konya, Turkey
| | - Hakan Hakki Taskapu
- Necmettin Erbakan Üniversitesi, Meram Faculty of Medicine, Department of Urology - Konya, Turkey
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Javanmardifard S, Gheibizadeh M, Shirazi F, Zarea K, Ghodsbin F. Psychosocial Experiences of Older Women in the Management of Urinary Incontinence: A Qualitative Study. Front Psychol 2022; 13:785446. [PMID: 35350738 PMCID: PMC8957818 DOI: 10.3389/fpsyg.2022.785446] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 02/14/2022] [Indexed: 11/14/2022] Open
Abstract
Introduction Urinary incontinence is a prevalent disorder amongst older women. Identifying the psychosocial experiences of older women in disease management can improve the patient care process. Hence, the present study aimed to determine the psychosocial experiences of older women in the management of urinary incontinence. Methods This qualitative study was conducted using conventional content analysis. The study data were collected via unstructured in-depth face-to-face interviews with 22 older women suffering from urinary incontinence selected via purposive sampling. Sampling and data analysis were done simultaneously and were continued until data saturation. The interviews were recorded, transcribed, and analyzed using the method proposed by Graneheim and Lundman. Results The results indicated that the older people with urinary incontinence had various psychosocial experiences while living with and managing this disease. Accordingly, four main themes were extracted from the data as follows: “problem incompatibility with the disease,” “mental impasse,” “facing social restrictions,” and “concealment and social escapism.” Conclusion The findings demonstrated that older people with urinary incontinence experienced significant psychosocial pressures while living with this disorder, which affected their psychosocial well-being. Thus, paying attention to these psychosocial experiences while supporting and taking care of these patients can positively impact their psychosocial health and quality of life.
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Affiliation(s)
- Sorur Javanmardifard
- Student Research Committee, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Mahin Gheibizadeh
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fatemeh Shirazi
- Community Based Psychiatric Care Research Center, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Kourosh Zarea
- Nursing Care Research Center in Chronic Diseases, School of Nursing and Midwifery, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Fariba Ghodsbin
- Department of Nursing, School of Nursing and Midwifery, Shiraz University of Medical Sciences, Shiraz, Iran
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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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Sundqvist C, Li X, Sundquist K, Jansåker F. Sociodemographic Disparities and Parity in Relation to Urinary Incontinence: A Nationwide Primary Healthcare Cohort Study (1997–2018). J Clin Med 2022; 11:jcm11030496. [PMID: 35159948 PMCID: PMC8836927 DOI: 10.3390/jcm11030496] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 01/13/2022] [Accepted: 01/17/2022] [Indexed: 12/04/2022] Open
Abstract
Objectives: Urinary incontinence (UI) is a very common condition in the primary healthcare settings. Few studies have investigated whether sociodemographic factors are related to UI. This nationwide study aimed to investigate whether there is a relationship between sociodemographic factors and UI in women. Methods: A nationwide open cohort study included 2,044,065 women aged 15–50 years. Several national population-based (Sweden) databases including nationwide primary healthcare data were used. The outcome was the time to the first event of any UI diagnosis during the study period (1997–2018). Cox regression models were used to test for associations between individual sociodemographic factors and UI. Results: The study identified 44,250 UI events. These corresponded to 2.16% of the study population and an incidence rate (IR) per 1000 person-years of 1.85 (95% CI 1.84–1.87). In the fully adjusted model, a high age, low education level, and being born outside of Sweden were independently associated with a higher UI risk, while rural living was associated with a lower risk. The income level did not seem to have a large impact. Most notably, women born in the Middle East/North Africa and Latin America/Caribbean had a substantially higher risk of UI with HRs of 2.41 (95% CI 2.33–2.49) and 2.30 (95% CI 2.17–2.43), respectively. Parity was strongly and independently associated with UI. Conclusion: This study presents novel risk factors associated with UI. The findings provide new knowledge concerning the burden of this disease among women, which could be used to provide more equal healthcare for these patients in the future. Previous research allied with these findings suggests using a comprehensive approach targeting health disparities.
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Affiliation(s)
- Christoffer Sundqvist
- Center for Primary Health Care Research, Clinical Research Centre (CRC), Jan Waldenströms Gata 35, Region Skåne University Hospital, 20502 Malmö, Sweden; (C.S.); (X.L.); (K.S.)
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, 20502 Malmö, Sweden
| | - Xinjun Li
- Center for Primary Health Care Research, Clinical Research Centre (CRC), Jan Waldenströms Gata 35, Region Skåne University Hospital, 20502 Malmö, Sweden; (C.S.); (X.L.); (K.S.)
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, 20502 Malmö, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Clinical Research Centre (CRC), Jan Waldenströms Gata 35, Region Skåne University Hospital, 20502 Malmö, Sweden; (C.S.); (X.L.); (K.S.)
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, 20502 Malmö, Sweden
- Department of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Center for Community-Based Healthcare Research and Education (CoHRE), Department of Functional Pathology, School of Medicine, Shimane University, Matsue 690-0823, Japan
| | - Filip Jansåker
- Center for Primary Health Care Research, Clinical Research Centre (CRC), Jan Waldenströms Gata 35, Region Skåne University Hospital, 20502 Malmö, Sweden; (C.S.); (X.L.); (K.S.)
- Center for Primary Health Care Research, Department of Clinical Sciences Malmö, Lund University, 20502 Malmö, Sweden
- Correspondence: ; Tel.: +46-40391376
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Lee HY, Rhee Y, Choi KS. Urinary incontinence and the association with depression, stress, and self-esteem in older Korean Women. Sci Rep 2021; 11:9054. [PMID: 33907278 PMCID: PMC8079410 DOI: 10.1038/s41598-021-88740-4] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2020] [Accepted: 04/15/2021] [Indexed: 11/09/2022] Open
Abstract
The objectives were to investigate the prevalence of urinary incontinence (UI) and its relationships with depression, stress, and self-esteem in older Korean women from the Korean Study of Women's Health Related Issues (K-Stori), a nationally representative cross-sectional survey. A total of 3000 women between 65 and 79 years were the final study subjects. We applied multiple linear regression models to analyze associations with depression, stress, and self-esteem levels in relation to UI types. Types of urinary incontinence included stress, urge, and mixed UI. UI affects at least one in two older Korean women (52.2%). The prevalences of SUI, UUI, and MUI were 45.7%, 39.6%, and 33.1%, respectively. UI was found to be adversely associated with depression, stress, and self-esteem: women with UI reported significantly higher levels of depression and stress and lower levels of self-esteem than those without UI. Women with MUI reported significantly greater impairment than the women with SUI or UUI. Our results provide an evidence base for the evaluation of mental health in older women with incontinence. The prioritization of UI detection and the identification of psychological factors may help improve the diagnosis and management of UI and potentially yield significant economic and psychosocial benefits.
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Affiliation(s)
- Hoo-Yeon Lee
- Department of Social Medicine, College of Medicine, Dankook University, Chungnam, South Korea
| | - Yumie Rhee
- Division of Endocrinology, Department of Internal Medicine, Yonsei University College of Medicine, Seoul, South Korea
| | - Kui Son Choi
- Graduate School of Cancer Science and Policy, National Cancer Center, Goyang-si, South Korea.
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Alshammari S, Alyahya MA, Allhidan RS, Assiry GA, AlMuzini HR, AlSalman MA. Effect of Urinary Incontinence on the Quality of Life of Older Adults in Riyadh: Medical and Sociocultural Perspectives. Cureus 2020; 12:e11599. [PMID: 33240730 PMCID: PMC7681939 DOI: 10.7759/cureus.11599] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Objectives The objective of the study is to determine the impact of urinary incontinence (UI) on the quality of life (QoL) of the Saudi elderly population. Besides, we investigated individuals' help-seeking behaviors and the religious and cultural aspects of UI among the Saudi elderly. Methods We conducted a cross-sectional study using a random sample of 150 Saudi older adults of both genders. The participants were outpatient clinics of government and private hospitals in Riyadh from January-March 2019. Volunteer medical students interviewed and distributed a standard questionnaire form (Arabic version of the ICIQ-SF [International Consultation on Incontinence Questionnaire] with 33 additional questions, four of which came from them from the King's Health Questionnaire (KHQ) to the targeted population. Results In this study, there were 124 elderly participants (response rate 83%), of whom 62.9% were women. The mean age was 71.9 (±7.8). The "moderate" and "severe" ICIQ scores account for 78 (62.9%) and 32 (25.8%), respectively. There was a significant association between the ICIQ scores severity of UI and increasing BMI, nocturnal diuresis, urinary tract infection, and lung diseases. However, 36.3% of participants did not seek help due to misconceptions about UI and aging, unavailability of treatment, and embarrassment of sharing such symptoms with others. The participants suffered from limitations of social life (36.3%), a negative impact on their physical activity (18.5%), personal hygiene (21.8%), and their self-esteem (32.3%). About 17% and 33.1% of participants repeat ablution and prayers of participants, respectively. Conclusions Urinary incontinence (UI) is a common and distressing problem in the elderly. A large proportion of the participants had a detrimental effect on their quality of life. A substantial percentage of older adults did not seek help. As a result, we recommended raising awareness about UI, QoL, the misconceptions, and encourage them to overcome the stigma of embarrassment and seek medical help.
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Affiliation(s)
- Sulaiman Alshammari
- Family and Community Medicine, College of Medicine, King Saud University, Riyadh, SAU
| | - Malak A Alyahya
- Family and Community Medicine, College of Medicine, King Saud University, Riyadh, SAU
| | - Reema S Allhidan
- Family and Community Medicine, College of Medicine, King Saud University, Riyadh, SAU
| | - Ghadeer A Assiry
- Family and Community Medicine, College of Medicine, King Saud University, Riyadh, SAU
| | - Hissah R AlMuzini
- Family and Community Medicine, College of Medicine, King Saud University, Riyadh, SAU
| | - Munirah A AlSalman
- Family and Community Medicine, College of Medicine, King Saud University, Riyadh, SAU
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Sullivan R, McNicholas T, Claffey P, Kenny RA, Briggs R. Unreported urinary incontinence: population-based prevalence and factors associated with non-reporting of symptoms in community-dwelling people ≥ 50 years. Eur Geriatr Med 2020; 12:405-412. [PMID: 33029753 DOI: 10.1007/s41999-020-00412-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2020] [Accepted: 09/24/2020] [Indexed: 11/25/2022]
Abstract
PURPOSE Concerns exist around under-detection and under-treatment of urinary incontinence (UI) in specific patient groups, particularly older people. The aim of this study is to ascertain the prevalence of unreported UI in a large sample of older adults, to profile factors associated with under-reporting of UI and the association of unreported UI with quality of life (QOL). METHODS This study was embedded within the Irish Longitudinal Study on Ageing, involving a population-representative sample of almost 7,000 older adults (55% female, mean age 65 years). UI was defined as involuntary loss of urine from the bladder occurring on average at least twice per month. Unreported UI had not yet been reported to a healthcare professional. QOL was measured using the Control, Autonomy, Self-realisation and Pleasure-19 Scale (CASP-19). RESULTS Almost 40% (285/750) of participants with UI had not reported symptoms to a healthcare professional despite visiting their general practitioner (GP) on average over 4 times in the last year. Logistic regression modelling demonstrated that under-reporting of UI was associated with female sex, taking < 5 medications, less severe symptoms and lower number of GP visits. Linear regression models show that unreported UI was associated with significantly lower CASP-19 (β = - 1.20 (95% CI: - 2.19 to - 0.20)). CONCLUSION Only 40% of older people with UI report symptoms to a healthcare professional despite frequent symptoms, and a significant association with poorer QOL. This highlights the need to educate older people around seeking help for UI, as well as opportunistically addressing UI as part of comprehensive age-attuned care.
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Affiliation(s)
- Rachel Sullivan
- Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland
| | - Triona McNicholas
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
- Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland
| | - Paul Claffey
- Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland
| | - Rose Anne Kenny
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland
- Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland
- Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland
| | - Robert Briggs
- The Irish Longitudinal Study on Ageing (TILDA), Trinity College Dublin, Dublin, Ireland.
- Mercer's Institute for Successful Ageing, St. James's Hospital, Dublin, Ireland.
- Department of Medical Gerontology, Trinity College Dublin, Dublin, Ireland.
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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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Management of Urinary Incontinence With Underactive Bladder: A Review. Int Neurourol J 2020; 24:111-117. [PMID: 32615672 PMCID: PMC7332822 DOI: 10.5213/inj.2040076.038] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2020] [Accepted: 04/16/2020] [Indexed: 01/24/2023] Open
Abstract
Urinary incontinence is caused by storage function failure, while underactive bladder (UAB) is caused by a decline in detrusor contractility and voiding dysfunction. As the treatment mechanisms for incontinence and UAB are contrary to each other, it is difficult to treat both incontinence and UAB, and the patient’s quality of life can be further degraded. Conventional midurethral sling (MUS), such as transobturator tape or retropubic MUS, introduces a risk of postoperative voiding dysfunction in stress urinary incontinence with UAB. However, there have been several reports about the efficacy and safety of conventional MUS. Adjustable sling procedures, such as transobturator adjustable tape or the Remeex system, have better outcomes than conventional MUS because they control tension both during and after surgery. When voiding dysfunction occurs after incontinence treatment with UAB, voiding symptoms can be improved by various therapeutic modalities. Clean intermittent catheterization is recommended for patients with significant increased postvoid residual volumes or urinary retention. Although pharmacotherapy such as with alpha-blockers or parasympathomimetics can be considered for UAB, there is insufficient evidence of their effect on incontinence with UAB. Future therapies, such as stem cell therapy or gene therapy, may be used to treat incontinence with UAB. The possibility of management urgency urinary incontinence that related to detrusor hyperactivity with impaired contractility using sacral neuromodulation has been suggested. Further research is needed to establish evidence for the efficacy and safety of treatments for incontinence with UAB and improve patient quality of life.
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15
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Xu C, Chen M, Fu J, Meng Y, Qin S, Luo Y. Urinary incontinence status and risk factors in women aged 50-70 years: a cross-sectional study in Hunan, China. Int Urogynecol J 2020; 32:95-102. [PMID: 32095958 DOI: 10.1007/s00192-020-04259-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 02/11/2020] [Indexed: 12/19/2022]
Abstract
INTRODUCTION AND HYPOTHESIS Urinary incontinence (UI) is a common condition that may decrease women's quality of life. Risk factors remain debatable based on previous research. We aimed to determine the prevalence of UI and associated risk factors among women aged 50-70 years in Hunan, China. METHODS A cross-sectional study was conducted from May to August 2018 using a face-to-face questionnaire. In total, 2790 women aged 50-70 years were recruited using multi-stage stratified random sampling in Hunan. Dependent variable was UI. Independent variables were demographic characteristics, health behaviours, obstetric history and comorbidity. Data were entered into EpiData and analysed using SPSS. Chi-square tests were used to assess associations between categorical variables. Statistically significant variables (p ≤ 0.05) were then analysed by logistic regression. RESULTS The prevalence of UI was 14.84% (414/2790). Of the women with UI, 61.1% (253/414) had stress urinary incontinence (SUI), 21.5% (89/414) had urgency urinary incontinence (UUI), and 17.1% (72/414) had mixed urinary incontinence (MUI). Risk factors for UI included ageing, living in the countryside, history of gynaecological disease, hypertension and cardiovascular disease. CONCLUSIONS UI in women aged 50-70 years in Hunan was not as prevalent as reported in previous studies. Some possible reasons are addressed; for example, the primary survey in this study was not a UI-focused survey. Women who were older, lived in the countryside and had histories of gynaecological disease, hypertension or cardiovascular disease were more likely to have UI. Health departments and medical staff should target patients with factors that potential contribute to UI development.
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Affiliation(s)
- Chen Xu
- Xiang Ya Nursing School, Central South University, Changsha, China
| | - Mingzhu Chen
- Xiang Ya Nursing School, Central South University, Changsha, China
| | - Jingxia Fu
- Xiang Ya Nursing School, Central South University, Changsha, China
| | - Yanting Meng
- Xiang Ya Nursing School, Central South University, Changsha, China
| | - Si Qin
- Xiang Ya Nursing School, Central South University, Changsha, China
| | - Yang Luo
- Xiang Ya Nursing School, Central South University, Changsha, China.
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Tuong MNE, Patel NA, Zillioux JM, Rapp DE. Urinary Incontinence Research: Compliance With Research Standards for Clinical Studies. Urology 2019; 137:55-59. [PMID: 31794811 DOI: 10.1016/j.urology.2019.11.032] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2019] [Revised: 11/24/2019] [Accepted: 11/25/2019] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To perform an updated literature review to assess compliance with outcomes use and reporting guidelines. In 1997, the Urodynamics Society recommended standards of efficacy to be used for evaluation of treatment outcomes in urinary incontinence (UI). Studies published shortly after the release of these standards reported generally low rates of adherence. METHODS We reviewed all 2017 articles related to UI in 3 urologic journals (Journal of Urology [JU], Neurourology and Urodynamics [NU], and Urology [UR]). Articles were assessed for compliance with 19 standards across 3 categories (methodology, pretreatment, and post-treatment). Analysis focused on overall and category specific compliance, as well as comparison of compliance between journals. RESULTS A total of 78 articles met inclusion criteria for analysis. The mean overall compliance was 52% for all standards. JU demonstrated a higher compliance (63%) as compared to NU (50%) and UR (46%) (P <.01). No articles reviewed demonstrated 100% compliance with all standards. Only 23%, 6%, and 12% of JU, NU, and UR articles, respectively, demonstrated at least 75% compliance with all standards. In comparison of subcategory compliance, JU demonstrated a statistically higher methodology compliance (P <.01). In contrast, compliance with both pre- and post-treatment standards across all 3 journals demonstrated no statistically significant differences. CONCLUSION Overall, we found that a significant percentage of recent study on UI fails to meet suggested standards for use and reporting of outcomes. These data suggest that continued efforts are needed to improve the quality and reporting of UI research.
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Affiliation(s)
- Mei N E Tuong
- Department of Urology, University of Virginia, Charlottesville, VA
| | - Nickhil A Patel
- Department of Urology, University of Virginia, Charlottesville, VA
| | | | - David E Rapp
- Department of Urology, University of Virginia, Charlottesville, VA.
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Zhong D, Tang W, Geng D, He C. Efficacy and safety of acupuncture therapy for urinary incontinence in women: A systematic review and meta- analysis. Medicine (Baltimore) 2019; 98:e17320. [PMID: 31577726 PMCID: PMC6783143 DOI: 10.1097/md.0000000000017320] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Urinary incontinence (UI), affects women more frequently than men, with a prevalence to 30-40% of perimenopausal women and almost 50% among women aged over 70 years. caused severe psychological burden and bringing negatively impact to the quality of life, increased caregiver burden and economic cost. Acupuncture is often used to treat them. We aim to conduct a systematic review to evaluate the efficacy of acupuncture for women experiencing UI. METHODS The following electronic databases will be searched from inception to Jan. 2020: Cochrane Central Register of Controlled Trials (CENTRAL), PubMed, Web of Science, EMBASE, China National Knowledge Infrastructure (CNKI), Traditional Chinese Medicine, Chinese Biomedical Literature Database (CBM), Wan-Fang Database and Chinese Scientific Journal Database (VIP database).All published randomized controlled trials in English or Chinese related to acupuncture for urinary incontinence in women will be included. The primary outcome will be the change from baseline in the amount of urine leakage measured by the 1-hour pad test. Adverse events will be the secondary outcome. Study selection, data extraction, and assessment of study quality will be performed independently by two reviewers. RevMan V.5.3.5 software will be used for the assessment of risk of bias and data synthesis. RESULTS This study will provide a high-quality synthesis of current evidence of acupuncture for UI from the 1-hour pad test. CONCLUSION The conclusion of our study will provide an evidence to judge whether acupuncture is an effective intervention for patients suffered from UI. PROSPERO REGISTRATION NUMBER CRD42019133195.
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Affiliation(s)
- Dan Zhong
- Hospital of Chengdu University of Traditional Chinese Medicine
| | - Wenjun Tang
- Hospital of Chengdu University of Traditional Chinese Medicine
| | - Dan Geng
- Sichuan China 81 Rehabilitation Center, Chengdu, China
| | - Chengshi He
- Hospital of Chengdu University of Traditional Chinese Medicine
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Shahar S, Lau H, Puteh SEW, Amara S, Razak NA. Health, access and nutritional issues among low-income population in Malaysia: introductory note. BMC Public Health 2019; 19:552. [PMID: 31196021 PMCID: PMC6565540 DOI: 10.1186/s12889-019-6852-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The current issue of BMC Public Health presents work by the Consortium of Low Income Population Research (CB40R), highlighting a comprehensive aspect of health, i.e., physical health, mental health, health behaviour and health financing; and also nutrition involving all stages of lifespan of the socioeconomic deprived group in Malaysia.Consortium of B40 Research (CB40R) reposited and harmonised shared, non-identifiable data from epidemiological studies involving low income population (B40) in Malaysia. CB40R also performed joint or mega-analyses using combined, harmonised data sets that yield collated results with enhanced statistical power, more variabilities (study population, geographical regions, ethnicities and sociocultural groups) to better understand the needs, characteristics and issues of B40 groups in Malaysia. It also aimed to develope a system/framework of minimum/standard variables to be collected in research involving B40 in future. For this special issues, members of the consortium have been invited to contribute an original article involving analysis of the health aspects, access to health and nutritional issues of the B40 samples.All the papers in this special issue have successfully highlighted the health and nutritional issues (i.e., non-communicable disease (NCD), inflammatory bowel disease (IBD), knowledge towards sexually transmitted disease (STD), low birth weight, Motoric Cognitive Risk (MCR) syndrome, urinary incontinence), mental health, oral health and inequalities among the low-income group in Malaysia, including the rural population and also the urban poor. The low-income population in Malaysia is also at risk of both under- and over nutrition, of which specific cost effective strategies are indeed needed to improve their quality of life.The low income population in Malaysia is facing various health challenges, particularly related to NCD and poor mental health, nutritional and physical function. There is a need for a sustainable intervention model to tackle the issues. It is also important to highlight that reducing SES disparities in health will require policy initiatives addressing the components of socioeconomic status (income, education, and occupation) as well as the pathways by which these affect health.
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Affiliation(s)
- Suzana Shahar
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda A. Aziz, 50300 Kuala Lumpur, Malaysia
| | - Huijin Lau
- Centre for Healthy Aging and Wellness, Faculty of Health Sciences, Universiti Kebangsaan Malaysia, Jalan Raja Muda A. Aziz, 50300 Kuala Lumpur, Malaysia
| | - Sharifa Ezat Wan Puteh
- Department of Community Health, Faculty of Medicine, Universiti Kebangsaan Malaysia, Jalan Yaacob Latif, Bandar Tun Razak, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Sofia Amara
- International Life Sciences Institute (ILSI) Southeast Asia Region, 18 Mohamed Sultan Road #03-01, Singapore, 238967 Singapore
| | - Norizan Abdul Razak
- Women Leadership Centre, Universiti Kebangsaan Malaysia, 43000 Bangi, Selangor Malaysia
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