Abstract
To the Editor.— The careful study by Hu et al 1 is an important addition to the data regarding urinary incontinence in the nursing home. I write to request clarification of three points. First, I am astonished by the durability of the response in a group of patients as debilitated as the ones included in this study (mean Mini-Mental State Examination score, 12.7; Katz score, 5.3). While some patients may have been motivated and able to continue to ask for toileting assistance, as shown in Fig 2 of the article, this treatment effect decayed by more than 50%, while the reduction in incontinent episodes declined by only 16%. Moreover, it is difficult to envision nonresearch nurse assistants voluntarily continuing a toileting regimen that requires hourly checks of all incontinent residents. Could the durability be an artifact due to the return of the nurse research assistants every 2 months to reassess
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