Tags

Type your tag names separated by a space and hit enter

Urinary incontinence and its association with death, nursing home admission, and functional decline.
J Am Geriatr Soc. 2004 May; 52(5):712-8.JA

Abstract

OBJECTIVES

To determine whether urinary incontinence (UI) is an independent predictor of death, nursing home admission, decline in activities of daily living (ADLs), or decline in instrumental activities of daily living (IADLs).

DESIGN

A population-based prospective cohort study from 1993 to 1995.

SETTING

Community-dwelling within the United States.

PARTICIPANTS

Six thousand five hundred six of the 7,447 subjects aged 70 and older in the Asset and Health Dynamics Among the Oldest Old study who had complete information on continence status and did not require a proxy interview at baseline.

MEASUREMENTS

The predictor was UI, and the outcomes were death, nursing home admission, ADL decline, and IADL decline. Potential confounders considered were comorbid conditions, baseline function, sensory impairment, cognition, depressive symptoms, body mass index, smoking and alcohol, demographics, and socioeconomic status.

RESULTS

The prevalence of UI was 14.8% (18.5% in women; 8.5% in men). At 2-year follow-up, subjects incontinent at baseline were more likely to have died (10.9% vs 8.7%; unadjusted odds ratio (OR)=1.29, 95% confidence interval (CI)=1.02-1.64), be admitted to a nursing home (4.4% vs 2.6%, OR=1.77; 95% CI=1.18-2.63), and to have declined in ADL function (13.6% vs 8.1%; OR=1.78, 95% CI=1.36-2.33) and IADL function (21.2% vs 13.8%; OR 1.69, 95% CI 1.39-2.05). However, after adjusting for confounders, UI was not an independent predictor of death (adjusted OR (AOR)= 0.90, 95% CI=0.67-1.21), nursing home admission (AOR=1.33, 95% CI=0.86-2.04), or ADL decline (AOR=1.24, 95% CI=0.92-1.68). Incontinence remained a predictor of IADL decline (AOR=1.31; 95% CI=1.05-1.63), although adjustment markedly reduced the strength of this association.

CONCLUSION

Higher levels of baseline illness severity and functional impairment appear to mediate the relationship between UI and adverse outcomes. The results suggest that, although UI appears to be a marker of frailty in community-dwelling elderly, it is not a strong independent risk factor for death, nursing home admission, or functional decline.

Authors+Show Affiliations

San Francisco VA Medical Center, San Francisco, California, USA. Jayna.Holroyd-Leduc@med.va.govNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Research Support, U.S. Gov't, Non-P.H.S.
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

15086650

Citation

Holroyd-Leduc, Jayna M., et al. "Urinary Incontinence and Its Association With Death, Nursing Home Admission, and Functional Decline." Journal of the American Geriatrics Society, vol. 52, no. 5, 2004, pp. 712-8.
Holroyd-Leduc JM, Mehta KM, Covinsky KE. Urinary incontinence and its association with death, nursing home admission, and functional decline. J Am Geriatr Soc. 2004;52(5):712-8.
Holroyd-Leduc, J. M., Mehta, K. M., & Covinsky, K. E. (2004). Urinary incontinence and its association with death, nursing home admission, and functional decline. Journal of the American Geriatrics Society, 52(5), 712-8.
Holroyd-Leduc JM, Mehta KM, Covinsky KE. Urinary Incontinence and Its Association With Death, Nursing Home Admission, and Functional Decline. J Am Geriatr Soc. 2004;52(5):712-8. PubMed PMID: 15086650.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Urinary incontinence and its association with death, nursing home admission, and functional decline. AU - Holroyd-Leduc,Jayna M, AU - Mehta,Kala M, AU - Covinsky,Kenneth E, PY - 2004/4/17/pubmed PY - 2004/6/5/medline PY - 2004/4/17/entrez SP - 712 EP - 8 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 52 IS - 5 N2 - OBJECTIVES: To determine whether urinary incontinence (UI) is an independent predictor of death, nursing home admission, decline in activities of daily living (ADLs), or decline in instrumental activities of daily living (IADLs). DESIGN: A population-based prospective cohort study from 1993 to 1995. SETTING: Community-dwelling within the United States. PARTICIPANTS: Six thousand five hundred six of the 7,447 subjects aged 70 and older in the Asset and Health Dynamics Among the Oldest Old study who had complete information on continence status and did not require a proxy interview at baseline. MEASUREMENTS: The predictor was UI, and the outcomes were death, nursing home admission, ADL decline, and IADL decline. Potential confounders considered were comorbid conditions, baseline function, sensory impairment, cognition, depressive symptoms, body mass index, smoking and alcohol, demographics, and socioeconomic status. RESULTS: The prevalence of UI was 14.8% (18.5% in women; 8.5% in men). At 2-year follow-up, subjects incontinent at baseline were more likely to have died (10.9% vs 8.7%; unadjusted odds ratio (OR)=1.29, 95% confidence interval (CI)=1.02-1.64), be admitted to a nursing home (4.4% vs 2.6%, OR=1.77; 95% CI=1.18-2.63), and to have declined in ADL function (13.6% vs 8.1%; OR=1.78, 95% CI=1.36-2.33) and IADL function (21.2% vs 13.8%; OR 1.69, 95% CI 1.39-2.05). However, after adjusting for confounders, UI was not an independent predictor of death (adjusted OR (AOR)= 0.90, 95% CI=0.67-1.21), nursing home admission (AOR=1.33, 95% CI=0.86-2.04), or ADL decline (AOR=1.24, 95% CI=0.92-1.68). Incontinence remained a predictor of IADL decline (AOR=1.31; 95% CI=1.05-1.63), although adjustment markedly reduced the strength of this association. CONCLUSION: Higher levels of baseline illness severity and functional impairment appear to mediate the relationship between UI and adverse outcomes. The results suggest that, although UI appears to be a marker of frailty in community-dwelling elderly, it is not a strong independent risk factor for death, nursing home admission, or functional decline. SN - 0002-8614 UR - https://www.unboundmedicine.com/medline/citation/15086650/Urinary_incontinence_and_its_association_with_death_nursing_home_admission_and_functional_decline_ L2 - https://onlinelibrary.wiley.com/resolve/openurl?genre=article&sid=nlm:pubmed&issn=0002-8614&date=2004&volume=52&issue=5&spage=712 DB - PRIME DP - Unbound Medicine ER -