Urinary
incontinence (UI), also known as involuntary urination, is any uncontrolled
leakage of urine. It is a
common and distressing problem, which may have a large impact on quality of
life. In older women, UI
has been shown to be associated with impaired mobility, functional limitations,
and falls. And non-surgical therapies provide successful short-term
improvements and even cure in some women with UI. This study aimed to
characterize change in mobility within the community utilizing the Life Space
Assessment (LSA) questionnaire in women undergoing non-surgical UI treatment.
This prospective
cohort study, performed from July 2007 to March 2009, followed women seeking
non-surgical UI treatment from an outpatient tertiary-care clinic and assessed
their mobility and symptoms using LSA, Urogenital Distress Inventory (UDI-6),
and Incontinence Impact Questionnaire (IIQ-7) at baseline and 2, 6, and 12
months post-treatment. Estimated Percent Improvement (EPI) and Patient
Satisfaction Question (PSQ) were obtained post-treatment. The women were
treated with multi-component behavioral and/or pharmacologic therapies, and we
hypothesized that LSA would improve with treatment. Repeated measures analysis
with Tukey’s HSD and backwards selection linear regression model were
performed.
The results showed
that 70 ambulatory, community-dwelling women, aged 65 years or older, seeking
non-surgical care for UI were recruited. LSA score decreased from baseline to 2
months (mean ± SD; 63 ± 29 to 56 ± 28, p < 0.001) and was sustained at 6 and
12 months (54 ± 28, 54 ± 28). UDI scores improved from 36 ± 23 to 25 ± 24, p
< 0.001, at 2 months, and improvement persisted at 6 and 12 months (22 ± 22,
21 ± 24). Improvements in UDI and patient perceived improvement in UI were not
associated with LSA change. Age, race, and depression impacted LSA, which
decreased 1-point for each additional year of age (p = 0.004), 6-points for each
point higher on the Geriatric Depression Scale (GDS) (p = 0.002), and 6-point
for African American race (p = 0.048).
In conclusion, the
authors did not find improvement in mobility within the community utilizing the
validated LSA tool, with improvements in UI symptoms among women receiving
non-surgical treatments per individualized usual care. However, larger cohort
studies or clinical trials using the LSA when potentially greater improvements
in UI are expected, such as surgical intervention, should be performed to
better assess the relationship with UI and improvements in mobility related to
urinary incontinence among older women.
Article by Thomas
L. Wheeler II, et al, from USA.
Full access: http://suo.im/4xveeM
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