Abstract
OBJECTIVES: Urinary incontinence (UI) commonly occur in elderly people and it is associated with reduced functionality, quality of life and survival in older adults (65-80 years). Little is known about its impact in nonagenarians and centenarians. Thus, this study aimed to evaluate the health and mortality of nonagenarians and centenarians with UI.METHODS: Nonagenarians and centenarians residents of Porto Alegre, Brazil, participated in this cohort study and were followed between 2016 to 2019. Survival analysis were performed using Cox Proportional Hazards Regression methods in the simple and adjusted models.RESULTS: The overall prevalence of UI was 56%, 64% among women and 38% among men (p<0.01). UI was more frequent in widowers (p <0.01), those who left home (p=0.02) and participated in social activities less frequently (p=0.07). Also they had a higher frequency of chronic diseases (p = 0.02), more symptoms of depression (p=0.08) and reduced cognitive performance (p=0.04). Participants with UI had reduced survival in the simple (HR 0.29, p=0.23) and adjusted analysis (HR 0.33%, p=0.19). The variables that influenced the most, UI and mortality, were participation in social activities, ability to leave the home, cognitive performance and lower-limb function/mobility.CONCLUSIONS: Although UI was not a direct predictor, it was associated with reduced survival. Nonagenarians and centenarians with UI will likely experience a lower risk of mortality if they continue to participate in social activities, preserve their cognitive performance and practice physical activities.
Highlights
The aging process involves physiological changes that can facilitate the development of chronic, disabling and progressive diseases, compromising individuals’ independence and autonomy
The relationship between Urinary incontinence (UI) and marital status was more significant among widowers (p=0.005)
Urinary incontinence was a common condition reported by nonagenarians and centenarians
Summary
The aging process involves physiological changes that can facilitate the development of chronic, disabling and progressive diseases, compromising individuals’ independence and autonomy. It is known that the number of nonagenarians and centenarians is rising, even in developing countries. The high number of older adults who died without medical care suggests this population may have difficulty in accessing health care services and could be at risk of having care needs neglected. In this context, the need to identify factors related to survival, quality of life and quality of death in nonagenarians and centenarians was the main reason for the creation of the Project Multiprofessional Care for Oldest-Old (AMPAL), responsible for evaluating 245 people aged 90 years and older, since 2016.
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