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Predictors and Incidence of Urinary Incontinence in Elderly Canadians With and Without Dementia — A Five-Year Follow Up: The Canadian Study of Health and Aging

  • Truls Østbye (a1), Steinar Hunskaar (a2) and Elizabeth Sykes (a3)

Abstract

Based on the national Canadian Study of Health and Aging, the objective of this study was to determine the importance of socio-demographic and medical factors, cognitive and functional status as predictors of the development of urinary incontinence, and to estimate five-year incidence by sex and age group. Participants from the Canadian Study of Health and Aging who underwent a clinical examination in 1992 and were continent for urine at the time were followed up and their continence status was again determined in 1997. Multivariate logistic regression models with daily incontinence and daily or less than daily incontinence as the outcomes were developed separately for male (n = 306) and female (n = 520) survivors. Predictor variables were introduced in the following chunks: socio-demographic factors; cognitive status; functional status, diabetes and stroke. Five-year cumulative incidence of daily and less than daily incontinence by sex and age group was also estimated. Results indicated that the incidence of urinary incontinence was higher in women than in men, and increased by age in both men and women. Especially among men, those in institutions were much more likely to develop urinary incontinence than those in the community. Incontinence increased dramatically with severity of dementia, less so with physical immobility. Diabetes mellitus was related to the development incontinence in men but not in women, prior stroke was related to development of incontinence in both sexes. It is concluded that urinary incontinence is common in older persons, and enquiries about its presence should be part of routine medical and nursing assessment of older persons. Those who develop incontinence commonly have dementia and are physically impaired. The extent of assessment and management should be carefully tailored to each individual patient.

Inspirée de l'Étude sur la santé et le vieillissement au Canada, cette étude visait à déterminer l'importance des facteurs sociodémographiques et médicaux et de l'état cognitif et fonctionnel comme prédicteurs du développement de l'incontinence urinaire et à établir des prévisions d'incontinence sur cinq ans, selon le sexe et l'êge. Les sujets de l'Étude sur la santé et le vieillissement au Canada qui avaient subi un examen clinique en 1992 et qui ne souffraient pas d'incontinence urinaire à l'époque ont fait l'objet d'un suivi et leur état a été réévalué en 1997. On a établi les résultats en modèles distincts de régression logistique à plusieurs variables pour les hommes (n = 306) et les femmes (n = 520) survivants en ce qui a trait à l'incontinence quotidienne et à l'incontinence quotidienne ou inférieure. On a introduit des variables prédictives dans les catégories suivantes: facteurs sociodémographiques, état cognitif, état fonctionnel, diabète et ACV. On a également établi des prévisions d'incidence cumulative d'incontinence de cinq ans pour l'incontinence quotidienne et pour l'incontinence quotidienne ou inférieure, selon l'êge et le sexe. Les résultats indiquent que l'incidence d'incontinence urinaire est plus élevé chez les femmes que chez les hommes et qu'elle augmente avec l'êge dans les deux groupes. Particulièrement chez les hommes, les aîné(e)s en établissements sont beaucoup plus susceptibles de développer de l'incontinence urinaire que ceux qui demeurent dans leur milieu. L'incontinence augmente fortement lorsqu'il y a démence grave et pas nécessairement autant en cas d'immobilité physique. Le diabète sucré entraîne l'incontinence chez les hommes mais non chez les femmes. Un ACV s'associe à l'établissement de l'incontinence chez les deux sexes. En guise de conclusion, l'incontinence urinaire est commune chez les aîné(e)s et il faudrait déceler sa présence par des examens de routine et l'évaluation médicale des aîné(e)s. Les patients qui développent de l'incontinence souffrent souvent de démence et de déficience physique. La portée de l'évaluation et la gestion devraient être soigneusement établies en fonction de chaque patient.

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Corresponding author

Requests for offprints should be sent to:/Les demandes de tirés-à-part doivent être adressées à: Dr. Truls Østbye, Department of Community and Family Medicine, DUMC 2914, Duke University, Durham, NC 27710 U.S. (ostby001@mc.duke.edu)

Footnotes

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*The data reported in this article were collected as part of the Canadian Study of Health and Aging. The core study was funded by the Seniors' Independence Research Program, through the National Health Research and Development Program (NHRDP) of Health Canada (project no. 6606_3954_MC(S)). Additional funding was provided by the Division of Aging and Seniors, Health Canada. Pfizer Canada Incorporated through the Medical Research Council/ Pharmaceutical Manufacturers Association of Canada Health Activity Program, NHRDP (project no. 6603_1417_302(R)), Bayer Incorporated, and the British Columbia Health Research Foundation (projects no. 38 (93_2) and no. 34 (96_1)). The study was co-ordinated by the University of Ottawa and the Division of Aging and Seniors, Health Canada.

Footnotes

References

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Canadian Journal on Aging / La Revue canadienne du vieillissement
  • ISSN: 0714-9808
  • EISSN: 1710-1107
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