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Urinary incontinence in older community-dwelling women: the role of cognitive and physical function decline.
Obstet Gynecol. 2007 Apr; 109(4):909-16.OG

Abstract

OBJECTIVES

To examine the association between cognitive decline, physical function decline, and urinary incontinence in older community-dwelling women.

METHODS

This was an observational study of 6,361 community-dwelling women aged 65 years and older participating in the Study of Osteoporotic Fractures. Clinical frequency and functional disruptiveness of incontinence were assessed by self-report questionnaires. Cognitive function was assessed at visits using the modified Mini-Mental State Examination, Trails B test, and Digit Symbol Substitution Test. Physical function was assessed by measuring walking speed over a 6-meter course and time needed to complete five chair stands. Women were considered to have recent, significant decline in cognitive or physical function if their cognitive or physical performance declined by greater than 1 standard deviation beyond the mean decline in the 6 years preceding assessment of incontinence.

RESULTS

Women with recent physical function decline were more likely to report weekly incontinence (odds ratio [OR] 1.31, 95% confidence interval [CI] 1.09-1.56 for walking speed decline; OR 1.40, 95% CI 1.19-1.64 for chair stand decline), after adjusting for multiple characteristics. Women with recent cognitive decline were more likely to report incontinence that interfered with activities (OR 1.55, 95% CI 1.10-2.17 for modified Mini-Mental State Examination decline; OR 1.53, 95% CI 1.01-2.31 for Digit Symbol Substitution Test decline), after adjusting for multiple characteristics.

CONCLUSION

Both cognitive and physical function decline are likely important contributors to incontinence in community-dwelling women aged 65 years and older. Although cognitive decline may not be associated with greater frequency of incontinence, women with cognitive decline may have more difficulty coping with incontinence symptoms.

LEVEL OF EVIDENCE

II.

Authors+Show Affiliations

Veterans Affairs Medical Center, San Francisco, and University of California San Francisco, San Francisco, California 94121, USA. ahuang@ucsfmed.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17400853

Citation

Huang, Alison J., et al. "Urinary Incontinence in Older Community-dwelling Women: the Role of Cognitive and Physical Function Decline." Obstetrics and Gynecology, vol. 109, no. 4, 2007, pp. 909-16.
Huang AJ, Brown JS, Thom DH, et al. Urinary incontinence in older community-dwelling women: the role of cognitive and physical function decline. Obstet Gynecol. 2007;109(4):909-16.
Huang, A. J., Brown, J. S., Thom, D. H., Fink, H. A., & Yaffe, K. (2007). Urinary incontinence in older community-dwelling women: the role of cognitive and physical function decline. Obstetrics and Gynecology, 109(4), 909-16.
Huang AJ, et al. Urinary Incontinence in Older Community-dwelling Women: the Role of Cognitive and Physical Function Decline. Obstet Gynecol. 2007;109(4):909-16. PubMed PMID: 17400853.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Urinary incontinence in older community-dwelling women: the role of cognitive and physical function decline. AU - Huang,Alison J, AU - Brown,Jeanette S, AU - Thom,David H, AU - Fink,Howard A, AU - Yaffe,Kristine, AU - ,, PY - 2007/4/3/pubmed PY - 2007/4/27/medline PY - 2007/4/3/entrez SP - 909 EP - 16 JF - Obstetrics and gynecology JO - Obstet Gynecol VL - 109 IS - 4 N2 - OBJECTIVES: To examine the association between cognitive decline, physical function decline, and urinary incontinence in older community-dwelling women. METHODS: This was an observational study of 6,361 community-dwelling women aged 65 years and older participating in the Study of Osteoporotic Fractures. Clinical frequency and functional disruptiveness of incontinence were assessed by self-report questionnaires. Cognitive function was assessed at visits using the modified Mini-Mental State Examination, Trails B test, and Digit Symbol Substitution Test. Physical function was assessed by measuring walking speed over a 6-meter course and time needed to complete five chair stands. Women were considered to have recent, significant decline in cognitive or physical function if their cognitive or physical performance declined by greater than 1 standard deviation beyond the mean decline in the 6 years preceding assessment of incontinence. RESULTS: Women with recent physical function decline were more likely to report weekly incontinence (odds ratio [OR] 1.31, 95% confidence interval [CI] 1.09-1.56 for walking speed decline; OR 1.40, 95% CI 1.19-1.64 for chair stand decline), after adjusting for multiple characteristics. Women with recent cognitive decline were more likely to report incontinence that interfered with activities (OR 1.55, 95% CI 1.10-2.17 for modified Mini-Mental State Examination decline; OR 1.53, 95% CI 1.01-2.31 for Digit Symbol Substitution Test decline), after adjusting for multiple characteristics. CONCLUSION: Both cognitive and physical function decline are likely important contributors to incontinence in community-dwelling women aged 65 years and older. Although cognitive decline may not be associated with greater frequency of incontinence, women with cognitive decline may have more difficulty coping with incontinence symptoms. LEVEL OF EVIDENCE: II. SN - 0029-7844 UR - https://www.unboundmedicine.com/medline/citation/17400853/Urinary_incontinence_in_older_community_dwelling_women:_the_role_of_cognitive_and_physical_function_decline_ L2 - http://ovidsp.ovid.com/ovidweb.cgi?T=JS&PAGE=linkout&SEARCH=17400853.ui DB - PRIME DP - Unbound Medicine ER -