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Life Space Assessment in Older Women Undergoing Non-Surgical Treatment for Urinary Incontinence

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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