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Escribà-Salvans A, Jerez-Roig J, Farrés-Godayol P, Bezerra de Souza DL, Skelton DA, Minobes-Molina E. Health and sociodemographic determinants of excess mortality in Spanish nursing homes during the COVID-19 pandemic: a 2-year prospective longitudinal study. Z Gerontol Geriatr 2024:10.1007/s00391-024-02294-4. [PMID: 38625391 DOI: 10.1007/s00391-024-02294-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 03/06/2024] [Indexed: 04/17/2024]
Abstract
BACKGROUND Age, multimorbidity, immunodeficiency and frailty of older people living in nursing homes make them vulnerable to COVID-19 and overall mortality. OBJECTIVE To estimate overall and COVID-19 mortality parameters and analyse their predictive factors in older people living in nursing homes over a 2-year period. METHOD Design: A 2-year prospective longitudinal multicentre study was conducted between 2020 and 2022. SETTING This study involved five nursing homes in Central Catalonia (Spain). PARTICIPANTS Residents aged 65 years or older who lived in the nursing homes on a permanent basis. MEASUREMENTS Date and causes of deaths were recorded. In addition, sociodemographic and health data were collected. For the effect on mortality, survival curves were performed using the Kaplan-Meier method and multivariate analysis using Cox regression. RESULTS The total sample of 125 subjects had a mean age of 85.10 years (standard deviation = 7.3 years). There were 59 (47.2%) deaths at 24 months (95% confidence interval, CI, 38.6-55.9) and 25 (20.0%) were due to COVID-19, mostly in the first 3 months. In multivariate analysis, functional impairment (hazard ratio, HR 2.40; 95% CI 1.33-4.32) was a significant risk factor for mortality independent of age (HR 1.17; 95% CI 0.69-2.00) and risk of sarcopenia (HR 1.40; 95% CI 0.63-3.12). CONCLUSION Almost half of this sample of nursing home residents died in the 2‑year period, and one fifth were attributed to COVID-19. Functional impairment was a risk factor for overall mortality and COVID-19 mortality, independent of age and risk of sarcopenia.
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Affiliation(s)
- Anna Escribà-Salvans
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família 7, 08500, Vic, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | - Javier Jerez-Roig
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família 7, 08500, Vic, Spain.
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain.
- Department of Health Promotion and Rehabilitation, Institute of Sport Science and Innovations, Lithuanian Sports University, Kaunas, Lithuania.
| | - Pau Farrés-Godayol
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família 7, 08500, Vic, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
| | | | - Dawn A Skelton
- Research Centre for Health (ReaCH), School of Health and Life Sciences, Glasgow Caledonian University, Glasgow, UK
| | - Eduard Minobes-Molina
- Research group on Methodology, Methods, Models and Outcomes of Health and Social Sciences (M3O). Faculty of Health Sciences and Welfare. Centre for Health and Social Care Research (CESS), University of Vic-Central University of Catalonia (UVic-UCC), C. Sagrada Família 7, 08500, Vic, Spain
- Institute for Research and Innovation in Life Sciences and Health in Central Catalonia (IRIS-CC), Vic, Spain
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Zhang D, Gao L, Jia Y, Wang S, Wang H, Sun X, Wang J. Construction of Progress Prediction Model of Urinary Incontinence in Elderly Women: Protocol for a Multi-Center, Prospective Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:734. [PMID: 35055556 PMCID: PMC8775636 DOI: 10.3390/ijerph19020734] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 12/26/2021] [Accepted: 01/05/2022] [Indexed: 01/27/2023]
Abstract
BACKGROUND Urinary incontinence (UI) is a common health problem and seriously affects quality of life. Many women lack understanding of UI or are too ashamed to seek medical advice early, leading to a low treatment rate. The aim of this study is to establish an effective UI progress prediction model for elderly women with UI for earlier detection and better treatment. METHODS This study is conducted as a prospective, multi-center, cohort study, and recruits 800 women aged ≥60 with mild or moderate UI in China. Participants are divided into three groups: stress urinary incontinence group (SUI), urgency urinary incontinence group (UUI), and mixed urinary incontinence group (MUI). This study will investigate the general conditions of patients, after complete relevant pelvic floor function assessment, as well as after follow up at 6 months, 12 months, and 18 months by telephone. The primary endpoint is UI disease progress. Single factor and multi-factor Cox regression model analyses are undertaken to evaluate the associated risk factors affecting the progress of UI to establish a progress prediction model for elderly women. DISCUSSION This study will provide more predictive information for elderly women with UI, and new clinical references for the intervention and the treatment of UI for medical staff.
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Affiliation(s)
- Di Zhang
- Department of Obstetrics and Gynecology, Peking University People’s Hospital, No. 11, Xi-Zhi-Men South Street, Xi Cheng District, Beijing 100044, China; (D.Z.); (L.G.); (Y.J.); (S.W.); (J.W.)
- The Key Laboratory of Female Pelvic Floor Disorders, Beijing 100044, China
- Research Center of Female Pelvic Floor Disorders, Peking University, Beijing 100044, China
| | - Lei Gao
- Department of Obstetrics and Gynecology, Peking University People’s Hospital, No. 11, Xi-Zhi-Men South Street, Xi Cheng District, Beijing 100044, China; (D.Z.); (L.G.); (Y.J.); (S.W.); (J.W.)
- The Key Laboratory of Female Pelvic Floor Disorders, Beijing 100044, China
- Research Center of Female Pelvic Floor Disorders, Peking University, Beijing 100044, China
| | - Yuanyuan Jia
- Department of Obstetrics and Gynecology, Peking University People’s Hospital, No. 11, Xi-Zhi-Men South Street, Xi Cheng District, Beijing 100044, China; (D.Z.); (L.G.); (Y.J.); (S.W.); (J.W.)
- The Key Laboratory of Female Pelvic Floor Disorders, Beijing 100044, China
- Research Center of Female Pelvic Floor Disorders, Peking University, Beijing 100044, China
| | - Shiyan Wang
- Department of Obstetrics and Gynecology, Peking University People’s Hospital, No. 11, Xi-Zhi-Men South Street, Xi Cheng District, Beijing 100044, China; (D.Z.); (L.G.); (Y.J.); (S.W.); (J.W.)
- The Key Laboratory of Female Pelvic Floor Disorders, Beijing 100044, China
- Research Center of Female Pelvic Floor Disorders, Peking University, Beijing 100044, China
| | - Haibo Wang
- Clinical Research Institute, Peking University, Beijing 100191, China;
| | - Xiuli Sun
- Department of Obstetrics and Gynecology, Peking University People’s Hospital, No. 11, Xi-Zhi-Men South Street, Xi Cheng District, Beijing 100044, China; (D.Z.); (L.G.); (Y.J.); (S.W.); (J.W.)
- The Key Laboratory of Female Pelvic Floor Disorders, Beijing 100044, China
- Research Center of Female Pelvic Floor Disorders, Peking University, Beijing 100044, China
| | - Jianliu Wang
- Department of Obstetrics and Gynecology, Peking University People’s Hospital, No. 11, Xi-Zhi-Men South Street, Xi Cheng District, Beijing 100044, China; (D.Z.); (L.G.); (Y.J.); (S.W.); (J.W.)
- The Key Laboratory of Female Pelvic Floor Disorders, Beijing 100044, China
- Research Center of Female Pelvic Floor Disorders, Peking University, Beijing 100044, China
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Tai H, Liu S, Wang H, Tan H. Determinants of Urinary Incontinence and Subtypes Among the Elderly in Nursing Homes. Front Public Health 2021; 9:788642. [PMID: 34938714 PMCID: PMC8685234 DOI: 10.3389/fpubh.2021.788642] [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: 10/03/2021] [Accepted: 11/15/2021] [Indexed: 11/13/2022] Open
Abstract
Urinary incontinence (UI) is a common problem among older adults. This study investigated the prevalence of UI in nursing home residents aged ≥75 years in China and examined potential risk factors associated with UI and its subtypes. Data were collected during face-to-face interviews using a general questionnaire, the International Consultation Incontinence Questionnaire Short-Form, and the Barthel Index. A total of 551 participants aged ≥75 years residing in Changsha city were enrolled from June to December 2018. The UI prevalence rate among nursing home residents aged ≥75 years was 24.3%. The most frequent subtype was mixed (M) UI (38.1%), followed by urge (U) UI (35.1%), stress (S) UI (11.9%), and other types (14.9%). In terms of severity, 57.5% had moderate UI, while 35.1% had mild and 7.5% had severe UI. Constipation, immobility, wheelchair use, cardiovascular disease (CVD), and pelvic or spinal surgery were significant risk factors for UI. Participants with a history of surgery had higher risks of SUI (odds ratio [OR] = 4.87, 95% confidence interval [CI]: 1.55–15.30) and UUI (OR = 1.97, 95% CI: 1.05–3.71), those who were immobile or used a wheelchair had higher rates of MUI (OR = 11.07, 95% CI: 4.19–29.28; OR = 3.36, 95% CI: 1.16–9.78) and other UI types (OR = 7.89, 95% CI: 1.99–31.30; OR = 14.90, 95% CI: 4.88–45.50), those with CVD had a higher rate of UUI (OR = 2.25, 95% CI: 1.17–4.34), and those with diabetes had a higher risk of UUI (OR = 2.250, 95% CI: 1.14–4.44). Use of oral antithrombotic agents increased UUI risk (OR = 4.98, 95% CI: 2.10–11.85) whereas sedative hypnotic drug use was associated with a higher risk of MUI (OR = 3.62, 95% CI: 1.25–10.45). Each UI subtype has distinct risk factors, and elderly residents of nursing homes with a history of CVD and pelvic or spinal surgery who experience constipation should be closely monitored. Reducing time spent in bed and engaging in active rehabilitation including walking and muscle strengthening may aid in UI prevention and treatment.
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Affiliation(s)
- Hongyan Tai
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Shunying Liu
- Clinical Nursing Teaching and Research Section, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Haiqin Wang
- Geriatric Department, The Second Xiangya Hospital, Central South University, Changsha, China
| | - Hongzhuan Tan
- Xiangya School of Public Health, Central South University, Changsha, China
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