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The effect of urinary incontinence on quality of life in older nursing home residents.
J Am Geriatr Soc. 2006 Sep; 54(9):1325-33.JA

Abstract

OBJECTIVES

To determine whether nursing home residents with urinary incontinence (UI) have worse quality of life (QoL) than continent residents, whether the relationship between UI and QoL differs across strata of cognitive and functional impairment, and whether change in continence status is associated with change in QoL.

DESIGN

Retrospective cohort study using a Minimum Data Set (MDS) database to determine cross-sectional and longitudinal (6 month) associations between UI and QoL.

SETTING

All Medicare- or Medicaid-licensed nursing homes in Kansas, Maine, Mississippi, New York, and South Dakota during 1994 to 1996.

PARTICIPANTS

All residents aged 65 and older, excluding persons unable to void or with potentially unstable continence or QoL status (recent nursing home admission, coexistent delirium, large change in functional status, comatose, near death).

MEASUREMENTS

UI was defined as consistent leakage at least twice weekly over 3 months and continence as consistent dryness over 3 months. QoL was measured using the validated MDS-derived Social Engagement Scale.

RESULTS

Of 133,111 eligible residents, 90,538 had consistent continence status, 58,850 (65%) of whom were incontinent. UI was significantly associated with worse QoL in residents with moderate cognitive and functional impairment. New or worsening UI over 6 months was associated with worse QoL (odds ratio = 1.46, 95% confidence interval = 1.36-1.57) and was second only to cognitive decline and functional decline in predicting worse QoL.

CONCLUSION

This is the first study to quantitatively demonstrate that prevalent and new or worsening UI decreases QoL even in frail, functionally and cognitively impaired nursing home residents. These results provide a crucial incentive to improve continence care and quality in nursing homes and a rationale for targeting interventions to those residents most likely to benefit.

Authors+Show Affiliations

Section of Geriatrics, University of Chicago, Chicago, Illinois 60637, USA. cdubeau@medicine.bsd.uchicago.eduNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

16970638

Citation

Dubeau, Catherine E., et al. "The Effect of Urinary Incontinence On Quality of Life in Older Nursing Home Residents." Journal of the American Geriatrics Society, vol. 54, no. 9, 2006, pp. 1325-33.
Dubeau CE, Simon SE, Morris JN. The effect of urinary incontinence on quality of life in older nursing home residents. J Am Geriatr Soc. 2006;54(9):1325-33.
Dubeau, C. E., Simon, S. E., & Morris, J. N. (2006). The effect of urinary incontinence on quality of life in older nursing home residents. Journal of the American Geriatrics Society, 54(9), 1325-33.
Dubeau CE, Simon SE, Morris JN. The Effect of Urinary Incontinence On Quality of Life in Older Nursing Home Residents. J Am Geriatr Soc. 2006;54(9):1325-33. PubMed PMID: 16970638.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The effect of urinary incontinence on quality of life in older nursing home residents. AU - Dubeau,Catherine E, AU - Simon,Samuel E, AU - Morris,John N, PY - 2006/9/15/pubmed PY - 2006/10/21/medline PY - 2006/9/15/entrez SP - 1325 EP - 33 JF - Journal of the American Geriatrics Society JO - J Am Geriatr Soc VL - 54 IS - 9 N2 - OBJECTIVES: To determine whether nursing home residents with urinary incontinence (UI) have worse quality of life (QoL) than continent residents, whether the relationship between UI and QoL differs across strata of cognitive and functional impairment, and whether change in continence status is associated with change in QoL. DESIGN: Retrospective cohort study using a Minimum Data Set (MDS) database to determine cross-sectional and longitudinal (6 month) associations between UI and QoL. SETTING: All Medicare- or Medicaid-licensed nursing homes in Kansas, Maine, Mississippi, New York, and South Dakota during 1994 to 1996. PARTICIPANTS: All residents aged 65 and older, excluding persons unable to void or with potentially unstable continence or QoL status (recent nursing home admission, coexistent delirium, large change in functional status, comatose, near death). MEASUREMENTS: UI was defined as consistent leakage at least twice weekly over 3 months and continence as consistent dryness over 3 months. QoL was measured using the validated MDS-derived Social Engagement Scale. RESULTS: Of 133,111 eligible residents, 90,538 had consistent continence status, 58,850 (65%) of whom were incontinent. UI was significantly associated with worse QoL in residents with moderate cognitive and functional impairment. New or worsening UI over 6 months was associated with worse QoL (odds ratio = 1.46, 95% confidence interval = 1.36-1.57) and was second only to cognitive decline and functional decline in predicting worse QoL. CONCLUSION: This is the first study to quantitatively demonstrate that prevalent and new or worsening UI decreases QoL even in frail, functionally and cognitively impaired nursing home residents. These results provide a crucial incentive to improve continence care and quality in nursing homes and a rationale for targeting interventions to those residents most likely to benefit. SN - 0002-8614 UR - https://www.unboundmedicine.com/medline/citation/16970638/The_effect_of_urinary_incontinence_on_quality_of_life_in_older_nursing_home_residents_ L2 - https://doi.org/10.1111/j.1532-5415.2006.00861.x DB - PRIME DP - Unbound Medicine ER -