Factors associated with urinary and double incontinence in a geriatric post-hip fracture assessment in older women
Background Incontinence and hip fractures are common in older people, especially women, and associated with multiple adverse effects. Incontinence is a risk factor for falls. Aims We aimed to investigate the prevalence of urinary (UI) and double incontinence (DI, concurrent UI and faecal incontinenc...
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Published in | Aging clinical and experimental research Vol. 34; no. 6; pp. 1407 - 1418 |
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Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
Cham
Springer International Publishing
01.06.2022
Springer Nature B.V |
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Abstract | Background
Incontinence and hip fractures are common in older people, especially women, and associated with multiple adverse effects. Incontinence is a risk factor for falls.
Aims
We aimed to investigate the prevalence of urinary (UI) and double incontinence (DI, concurrent UI and faecal incontinence), and to identify factors associated with UI and DI 6 months post-fracture.
Methods
A prospective real-life cohort study was conducted consisting of 910 women aged ≥ 65 who were treated for their first hip fracture in Seinäjoki Central Hospital, Finland, between May 2008 and April 2018. Continence status was elicited at baseline and 6 months postoperatively at our geriatric outpatient clinic where all participants underwent a multidisciplinary comprehensive geriatric assessment (CGA) consisting of an evaluation of cognition, nutrition, mood, mobility, and functional ability.
Results
At baseline, 47% of the patients were continent, 45% had UI and 8% had DI, and at follow up, 38%, 52%, and 11%, respectively. The mean age of the patients was 82.7 ± 6.8. Both UI and DI were associated with functional disability and other factors related to frailty. The associations were particularly prominent for patients with DI who also had the worst performance in the domains of CGA. We identified several modifiable risk factors: depressive mood (odds ratio [OR] 1.81; 95% confidence interval [CI] 1.16–2.84) and constipation (OR 1.48, 95% CI 1.02–2.13) associated with UI and, late removal of urinary catheter (OR 2.33, 95% CI 1.31–4.14), impaired mobility (OR 2.08, 95% CI 1.05–4.15), and poor nutrition (OR 2.31, 95% CI 1.11–4.79) associated with DI.
Conclusions
This study demonstrates a high prevalence of UI and DI in older women with hip fracture and modifiable risk factors, which should be targeted in orthogeriatric management and secondary falls prevention. Patients with DI were found to be an especially vulnerable group. |
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AbstractList | Background
Incontinence and hip fractures are common in older people, especially women, and associated with multiple adverse effects. Incontinence is a risk factor for falls.
Aims
We aimed to investigate the prevalence of urinary (UI) and double incontinence (DI, concurrent UI and faecal incontinence), and to identify factors associated with UI and DI 6 months post-fracture.
Methods
A prospective real-life cohort study was conducted consisting of 910 women aged ≥ 65 who were treated for their first hip fracture in Seinäjoki Central Hospital, Finland, between May 2008 and April 2018. Continence status was elicited at baseline and 6 months postoperatively at our geriatric outpatient clinic where all participants underwent a multidisciplinary comprehensive geriatric assessment (CGA) consisting of an evaluation of cognition, nutrition, mood, mobility, and functional ability.
Results
At baseline, 47% of the patients were continent, 45% had UI and 8% had DI, and at follow up, 38%, 52%, and 11%, respectively. The mean age of the patients was 82.7 ± 6.8. Both UI and DI were associated with functional disability and other factors related to frailty. The associations were particularly prominent for patients with DI who also had the worst performance in the domains of CGA. We identified several modifiable risk factors: depressive mood (odds ratio [OR] 1.81; 95% confidence interval [CI] 1.16–2.84) and constipation (OR 1.48, 95% CI 1.02–2.13) associated with UI and, late removal of urinary catheter (OR 2.33, 95% CI 1.31–4.14), impaired mobility (OR 2.08, 95% CI 1.05–4.15), and poor nutrition (OR 2.31, 95% CI 1.11–4.79) associated with DI.
Conclusions
This study demonstrates a high prevalence of UI and DI in older women with hip fracture and modifiable risk factors, which should be targeted in orthogeriatric management and secondary falls prevention. Patients with DI were found to be an especially vulnerable group. BACKGROUNDIncontinence and hip fractures are common in older people, especially women, and associated with multiple adverse effects. Incontinence is a risk factor for falls. AIMSWe aimed to investigate the prevalence of urinary (UI) and double incontinence (DI, concurrent UI and faecal incontinence), and to identify factors associated with UI and DI 6 months post-fracture. METHODSA prospective real-life cohort study was conducted consisting of 910 women aged ≥ 65 who were treated for their first hip fracture in Seinäjoki Central Hospital, Finland, between May 2008 and April 2018. Continence status was elicited at baseline and 6 months postoperatively at our geriatric outpatient clinic where all participants underwent a multidisciplinary comprehensive geriatric assessment (CGA) consisting of an evaluation of cognition, nutrition, mood, mobility, and functional ability. RESULTSAt baseline, 47% of the patients were continent, 45% had UI and 8% had DI, and at follow up, 38%, 52%, and 11%, respectively. The mean age of the patients was 82.7 ± 6.8. Both UI and DI were associated with functional disability and other factors related to frailty. The associations were particularly prominent for patients with DI who also had the worst performance in the domains of CGA. We identified several modifiable risk factors: depressive mood (odds ratio [OR] 1.81; 95% confidence interval [CI] 1.16-2.84) and constipation (OR 1.48, 95% CI 1.02-2.13) associated with UI and, late removal of urinary catheter (OR 2.33, 95% CI 1.31-4.14), impaired mobility (OR 2.08, 95% CI 1.05-4.15), and poor nutrition (OR 2.31, 95% CI 1.11-4.79) associated with DI. CONCLUSIONSThis study demonstrates a high prevalence of UI and DI in older women with hip fracture and modifiable risk factors, which should be targeted in orthogeriatric management and secondary falls prevention. Patients with DI were found to be an especially vulnerable group. Incontinence and hip fractures are common in older people, especially women, and associated with multiple adverse effects. Incontinence is a risk factor for falls. We aimed to investigate the prevalence of urinary (UI) and double incontinence (DI, concurrent UI and faecal incontinence), and to identify factors associated with UI and DI 6 months post-fracture. A prospective real-life cohort study was conducted consisting of 910 women aged ≥ 65 who were treated for their first hip fracture in Seinäjoki Central Hospital, Finland, between May 2008 and April 2018. Continence status was elicited at baseline and 6 months postoperatively at our geriatric outpatient clinic where all participants underwent a multidisciplinary comprehensive geriatric assessment (CGA) consisting of an evaluation of cognition, nutrition, mood, mobility, and functional ability. At baseline, 47% of the patients were continent, 45% had UI and 8% had DI, and at follow up, 38%, 52%, and 11%, respectively. The mean age of the patients was 82.7 ± 6.8. Both UI and DI were associated with functional disability and other factors related to frailty. The associations were particularly prominent for patients with DI who also had the worst performance in the domains of CGA. We identified several modifiable risk factors: depressive mood (odds ratio [OR] 1.81; 95% confidence interval [CI] 1.16-2.84) and constipation (OR 1.48, 95% CI 1.02-2.13) associated with UI and, late removal of urinary catheter (OR 2.33, 95% CI 1.31-4.14), impaired mobility (OR 2.08, 95% CI 1.05-4.15), and poor nutrition (OR 2.31, 95% CI 1.11-4.79) associated with DI. This study demonstrates a high prevalence of UI and DI in older women with hip fracture and modifiable risk factors, which should be targeted in orthogeriatric management and secondary falls prevention. Patients with DI were found to be an especially vulnerable group. Abstract Background Incontinence and hip fractures are common in older people, especially women, and associated with multiple adverse effects. Incontinence is a risk factor for falls. Aims We aimed to investigate the prevalence of urinary (UI) and double incontinence (DI, concurrent UI and faecal incontinence), and to identify factors associated with UI and DI 6 months post-fracture. Methods A prospective real-life cohort study was conducted consisting of 910 women aged ≥ 65 who were treated for their first hip fracture in Seinäjoki Central Hospital, Finland, between May 2008 and April 2018. Continence status was elicited at baseline and 6 months postoperatively at our geriatric outpatient clinic where all participants underwent a multidisciplinary comprehensive geriatric assessment (CGA) consisting of an evaluation of cognition, nutrition, mood, mobility, and functional ability. Results At baseline, 47% of the patients were continent, 45% had UI and 8% had DI, and at follow up, 38%, 52%, and 11%, respectively. The mean age of the patients was 82.7 ± 6.8. Both UI and DI were associated with functional disability and other factors related to frailty. The associations were particularly prominent for patients with DI who also had the worst performance in the domains of CGA. We identified several modifiable risk factors: depressive mood (odds ratio [OR] 1.81; 95% confidence interval [CI] 1.16–2.84) and constipation (OR 1.48, 95% CI 1.02–2.13) associated with UI and, late removal of urinary catheter (OR 2.33, 95% CI 1.31–4.14), impaired mobility (OR 2.08, 95% CI 1.05–4.15), and poor nutrition (OR 2.31, 95% CI 1.11–4.79) associated with DI. Conclusions This study demonstrates a high prevalence of UI and DI in older women with hip fracture and modifiable risk factors, which should be targeted in orthogeriatric management and secondary falls prevention. Patients with DI were found to be an especially vulnerable group. |
Author | Ala-Nissilä, Seija Sinikka Nuotio, Maria Susanna Hellman-Bronstein, Aino Tuulikki Luukkaala, Tiina Hannele Kujala, Minna Anneli |
Author_xml | – sequence: 1 givenname: Aino Tuulikki orcidid: 0000-0003-0438-7866 surname: Hellman-Bronstein fullname: Hellman-Bronstein, Aino Tuulikki email: athell@utu.fi organization: Division of Geriatric Medicine, Department of Clinical Medicine, University of Turku – sequence: 2 givenname: Tiina Hannele surname: Luukkaala fullname: Luukkaala, Tiina Hannele organization: Research, Development and Innovation Center, Tampere University Hospital, Health Sciences, Faculty of Social Sciences, Tampere University – sequence: 3 givenname: Seija Sinikka surname: Ala-Nissilä fullname: Ala-Nissilä, Seija Sinikka organization: Department of Obstetrics and Gynecology, Turku University Hospital, Department of Clinical Medicine, University of Turku – sequence: 4 givenname: Minna Anneli surname: Kujala fullname: Kujala, Minna Anneli organization: Division of Geriatric Medicine, Department of Clinical Medicine, University of Turku, Department of Geriatric Medicine, Seinäjoki Central Hospital – sequence: 5 givenname: Maria Susanna surname: Nuotio fullname: Nuotio, Maria Susanna organization: Division of Geriatric Medicine, Department of Clinical Medicine, University of Turku, Department of Geriatric Medicine, Seinäjoki Central Hospital, Research Services and Department of Clinical Medicine, Turku University Hospital, Welfare Division, City of Turku |
BackLink | https://www.ncbi.nlm.nih.gov/pubmed/34984652$$D View this record in MEDLINE/PubMed |
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CitedBy_id | crossref_primary_10_1016_j_archger_2022_104901 crossref_primary_10_1186_s12877_023_04597_4 crossref_primary_10_1186_s12877_023_04637_z crossref_primary_10_1093_ageing_afad258 crossref_primary_10_1136_bmjopen_2022_065544 crossref_primary_10_1007_s41999_024_00997_w crossref_primary_10_3390_jcm12103352 |
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Keywords | Urinary incontinence Frailty Hip fracture Double incontinence |
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Snippet | Background
Incontinence and hip fractures are common in older people, especially women, and associated with multiple adverse effects. Incontinence is a risk... Incontinence and hip fractures are common in older people, especially women, and associated with multiple adverse effects. Incontinence is a risk factor for... Abstract Background Incontinence and hip fractures are common in older people, especially women, and associated with multiple adverse effects. Incontinence is... BackgroundIncontinence and hip fractures are common in older people, especially women, and associated with multiple adverse effects. Incontinence is a risk... BACKGROUNDIncontinence and hip fractures are common in older people, especially women, and associated with multiple adverse effects. Incontinence is a risk... |
SourceID | pubmedcentral proquest crossref pubmed springer |
SourceType | Open Access Repository Aggregation Database Index Database Publisher |
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SubjectTerms | Aged Cohort Studies Falls Fecal incontinence Fecal Incontinence - epidemiology Female Fractures Geriatric Assessment Geriatrics Geriatrics/Gerontology Hip Fractures - complications Hip Fractures - epidemiology Hip Fractures - surgery Humans Injury prevention Medicine Medicine & Public Health Original Original Article Prospective Studies Risk Factors Urinary Incontinence - epidemiology |
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Title | Factors associated with urinary and double incontinence in a geriatric post-hip fracture assessment in older women |
URI | https://link.springer.com/article/10.1007/s40520-021-02046-z https://www.ncbi.nlm.nih.gov/pubmed/34984652 https://www.proquest.com/docview/2671454200 https://search.proquest.com/docview/2616960788 https://pubmed.ncbi.nlm.nih.gov/PMC9151507 |
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