UI is often multifactorial in etiology next to physiological age-related changes in lower urinary tract function, risk factors outside the lower urinary tract, such as co-existing disabilities and comorbidities, are causing or contributing to UI. Studies which define UI as any involuntary leakage of urine showed a prevalence between 72 and 78% in women living in nursing homes. With an aging population in Western countries, the prevalence of UI and associated problems is increasing rapidly. The annual direct costs of UI in the United States were estimated at US$ 19.5 billion in 2000, with US$ 5.3 billion for institutionalized old people. Beside this individual burden, UI is associated with higher healthcare resource utilization. Furthermore, UI is a predictor of death and mortality rate increases in parallel with UI severity, as shown in a group of community-dwelling participants receiving home care services. UI impairs the person’s independence and can trigger nursing home admission, even though data whether UI is a predicting factor for nursing home admission were inconsistent in a systematic review.
Functional incontinence professional#
Old people with UI are more dependent on professional services.
It is associated with a significantly reduced health-related quality of life and depression. Urinary incontinence (UI) has a profound impact on an affected woman’s life. Physical more than cognitive training in order to improve or at least stabilize ADL performance could be a way to prevent or reduce the process of developing UI. The study indicated that impairment in ADL performance is strongly associated with UI, more than CPS performance and comorbidities. Of the 11 examined comorbid conditions, only diabetes mellitus (OR 1.19), dementia (OR 1.01) and arthrosis/arthritis (OR 1.53) were significantly associated with UI. Considering the interaction between ADL and CPS, all ADL hierarchies remained significantly associated with UI, however for CPS this was the case only in the lower hierarchies. For CPS, the OR for UI from “borderline intact” to “very severe impairment” was 1.35 – 5.99. There was a gradual increase in the odds ratio (OR) for UI depending on the ADL hierarchy scale, from the hierarchy scales of “supervised” to “total dependence” of 1.43 – 30.25. Statistical analysis was done by means of descriptive statistics and logistic regression analysis. Wome n ≥65 years were included ( n = 44’811 January 2005 to September 2014) at the time of admission to a nursing home. The analysis examined the effect of ADL hierarchy scale, CPS, joint motion and comorbidities on UI. The cross-sectional retrospective analysis of 357 nursing homes in Switzerland was based on data of the Minimum Data Set of the Resident Assessment Instrument 2.0 (RAI-MDS). The purpose of this study was to determine the association between UI and the activities of daily living (ADL) hierarchy scale, the cognitive performance scale (CPS) and comorbid conditions. Specific knowledge of urinary incontinence (UI) and its interrelation with physical and cognitive health is essential to working towards prevention of UI and to improving quality of treatment and care.
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