Incontinence In Older People Research Articles

Incontinence in the elderly

Geriatric incontinence is a prevalent problem, morbid, costly and has effects that are devastating, causing psychological dysfunction, which often leads to isolation and early admission to a residential care facility. The reported prevalence of urinary incontinence (UI) in the elderly varied widely between 10% and 70% in those over 65 years of age. There is evidence that less than half of the patients with UI consult their healthcare provider. Incontinence is associated with significant anxiety and depression which has negative effect on self perception. Continence depends on multiple factors – mental state, mobility, manual dexterity, health status and motivation – as well as urinary function. The aetiology and risk factors of incontinence in older people are little different from those in younger age groups but the elderly are more prone to physiological, pharmacological and psychological factors that may affect their incontinence status. Assessment of elderly patients with UI should follow a holistic approach; it must include transfer ability, mobility, balance, arm strength and body flexibility, manual dexterity, eyesight and toileting ability. Simple conservative measures such as general lifestyle advice are all that is needed in many cases. Primary care team including continence advisors play important role in treating these patients. Pelvic-floor exercise, bladder retraining and biofeedback are useful first-line management, but they require intact cognitive function and motivation. Due to the side effects, older people should be observed carefully when given new medications, and polypharmacy should be avoided at all cost. Age in itself is not a barrier to surgical treatment, especially if performed under local anaesthesia. Environmental measures are an essential part of the treatment package. Preventive strategies should be used, when possible, to reduce the burden of incontinence on elderly sufferers and enhance their quality of life.

Five-Year Follow-up of Urinary Incontinence in Older People in a Spanish Rural Population

To determine prevalence, incidence and remission rates and change patterns of urinary incontinence (UI) over a 5-year time span. Longitudinal study. Basic Health Zone of Cabra (Cordoba). A random age-stratified sample of 827 subjects selected from a total of 5139 persons > or = 65 years of age and followed up between 1996 and 2001. Home interview. Questions about detection and level of severity of UI, sociodemographic data, and level of functioning. Two logistic regression models were created to identify risk factors for the probability to be alive and to develop UI, respectively. UI prevalence reached 36% at baseline and 46% five years later. Mortality rates were similar in continent and incontinent subjects. 54.5% of continent subjects in 1996 remained so in 2001. Five-year incidence and remission rates were 29% and 15%, respectively. In both sexes, slight and moderate incontinence mainly progressed to moderate and severe degrees, whereas severe UI remained unchanged in 40.1%. The main risk factors for increased survival and for UI incidence were self-rated health and level of functioning. Prevalence of UI is high, incidence is moderate and remission is low. Urinary incontinence is a dynamic problem and does not affect mortality. Impaired mobility has a strong influence on UI incidence.

Introduction

Introduction

The prevalence of faecal incontinence in older people living at home.

faecal incontinence affects quality of life and causes caregiver strain. Patients are often reluctant to seek help because of embarrassment and perceived lack of effective treatment. Persisting faecal soiling may lead to unwanted and premature institutionalization. to ascertain the prevalence of faecal incontinence and to identify health and socio-demographic characteristics of patients with this problem. a sample of 3000 older people, living at home in the UK, randomly selected from three Family Health Service Authorities. we interviewed 2818 men and women aged > or =65 years in their own homes: a response rate of 94%. 78 respondents (3%) reported faecal incontinence. There was a small but non-significant association with increasing age: 38 (2%) of those reporting incontinence were aged 65-74 years; 40 (3%) were aged > or =75 years. Faecal incontinence was significantly associated with sex, with reports from 15 men (1%) versus 63 women (4%; P<0.0005). It was also significantly associated with anxiety and with depression (P<0.00001) and very significantly associated with increasing disability (P<0.00001). Forty-six (59%) of those who had faecal incontinence had severe disability, compared with 426 (16%) of those who did not (P<0.00001). The association with urinary incontinence was also strong: 54 (69%) of those with faecal incontinence (2% of the total sample) had coexistent urinary incontinence. Over 50% had not discussed their problems with a healthcare professional. a reluctance to report symptoms and a significant association between faecal incontinence and symptoms of anxiety, depression and disability suggest that older people should be asked about faecal incontinence. Increasing the awareness of the scale of the problem among health- and social-care professionals, older people and their carers may lead to more appropriate management and effective provision of care.

Medical Evaluation of Causes of Lower Urinary Tract Symptoms and Urinary Incontinence in Older People

The common problems of lower urinary tract symptoms and urinary incontinence are ideally addressed in a multidisciplinary setting. This article describes pathophysiologic and age-related changes to micturition as well as causes of transient and established incontinence and nocturia. It includes a description of the process of assessment, guidelines for a detailed history and examination and bladder charting, and it concludes with basic and subsequent evaluation. Goals of treatment change according to patient needs, while assessment varies in depth depending on a patient's functional state. It is hoped that the end result for all patients is independent, dependent, or social continence or a combination of these.

Prevalence and psychosocial impact of urinary incontinence in older people of a Spanish rural population.

The prevalence and the psychosocial impact of urinary incontinence in older people of a rural population were investigated. A cross-sectional study was made by means of a home health interview in a representative sample of people aged 65 years and older in the Basic Health Zone of Cabra (Córdoba). A questionnaire was used with two questions to detect urinary incontinence and further questions regarding its duration, frequency, volume, severity and psychosocial impact. Data were analyzed with basic statistics. A logistic regression model was created to identify which factors affect people's lifestyles. Among the 827 respondents the prevalence of incontinence reached 36% [95% confidence interval (CI): 34%-38%] and was higher (p < .001) in women (42%; 95% CI: 39%-45%) than in men (29%; 95% CI: 25%-38%). The most frequent duration of incontinence was from 1 to 5 years (16.8%). Fifteen percent had daily episodes and 10.6% estimated the volume of urine loss as high. Incontinence was severe in 9% of the affected subjects. Half the incontinent subjects expressed social limitations and negative feelings related to incontinence, and 21% admitted that incontinence negatively affected their lives. In the logistic regression model, both volume of urine loss [odds ratio (OR) = 5.61; 95% CI: 2.76-11.42] and being married (OR = 2.34; 95% CI: 1.03-5.33) were the factors statistically associated with a negative influence of incontinence on lifestyle. Urinary incontinence is a very frequent symptom in our population. Half the incontinent subjects suffer from some degree of psychosocial limitation. The volume of urine loss and being married are the most important factors with psychosocial impact.

Prevention of urinary incontinence in older people.

Prevention of urinary incontinence in older people.

The Continued Success Of Conservative Management For Established Urinary Incontinence In Older People

Seventy‐eight community residing patients (63% women) aged 60 years or older attending an outpatient continence clinic were randomised to receive immediate conservative (non‐surgical, non‐pharmacological) management or to a control group in which treatment was deferred for two months. All patients were followed up for 12 months. Outcome was assessed by three day bladder charts (objectively) and by patient questionnaires (subjectively). The average age was 74.8 yean and mean duration of incontinence was 7.3 years with 60% not having had any previous treatment. After four months of active treatment incontinence was cured or improved subjectively in 88% of patients and objectively in 58% of patients. This was sustained through to the 12 month follow‐up. Severity of incontinence was significantly reduced on a range of variables.Conservative management of elderly community‐based patients can be very effective, taking up to four months to see peak benefit which can be sustained over a 12 month period with little additional input. The improvement seen in the control group perhaps reflects the importance of support and destigmatisation of this condition.

Volume-interval relationship of incontinence episodes in elderly inpatient men

Urinary incontinence is an immense source of personal distress for older people. The characteristics of urinary incontinence in older people that contribute to understanding the pathophysiology of incontinence have not been studied extensively. In this study, 66 elderly inpatients were monitored for incontinence characteristics of incontinence volume and time interval between episodes. There was no correlation between incontinence volume and time between episodes of incontinence. This supports a previous observation that the occurrence of urinary incontinence in elderly inpatient men is not determined by the accumulated volume of urine in the bladder.

AGEIST ATTITUDES PROMOTE URINARY INCONTINENCE IN OLDER PEOPLE AND CAN LEAD TO THE DEMORALISATION OF NURSING STAFF

AbstractThe purpose of this paper is to analyse some myths surrounding ageing. The particular focus is on myths associated with urinary incontinence in older people. It is suggested that nursing attitudes of acceptance and apathy promote urinary incontinence. The result of these attitudes is that the nursing profession demeans itself and creates an unfavourable environment in which to work.

Study of the prevalence and management of patients with faecal incontinence in old people's homes.

Study of the prevalence and management of patients with faecal incontinence in old people's homes.

Bladder training and related therapies for urinary incontinence in older people

Bladder training and related therapies for urinary incontinence in older people

Bladder Training and Related Therapies for Urinary Incontinence in Older People

In recent years, several studies have reported that bladder training, a behavioral intervention in which the interval between voluntary voidings is gradually extended, is an effective therapy for "urge" urinary incontinence (incontinence often associated with inability to inhibit detrusor contractions). Related behavioral therapies may also be effective for incontinence associated with impaired mobility and cognitive status. Because all of these types of incontinence are particularly common among older persons, the effectiveness of these therapies in this age group deserves attention. However, few well-controlled trials have been conducted with older subjects. There are many pathophysiologic types of incontinence among the older population, which is also heterogeneous in important clinical and functional characteristics that affect response to treatment. Hence, clinical trials that characterize subjects' urodynamic, neurologic, cognitive, and functional status, as well as the presence of other diseases and medication use, are needed to determine which elderly persons are likely to respond to particular behavioral regimens for urinary incontinence.

FAECAL INCONTINENCE IN RESIDENTIAL HOMES FOR THE ELDERLY: PREVALENCE, AETIOLOGY AND MANAGEMENT

Faecal incontinence occurring at least once weekly was found in 10.3% of residents in 30 residential homes for the elderly. Fifty-two randomly-selected incontinent residents were prescribed treatment and the outcome was compared with 30 incontinent residents acting as controls. The vast majority of all incontinent residents showed evidence of chronic brain failure (dementia). Incontinence had been present for over a year in 73%, yet only 4% had been referred to their general practitioner. Incontinence secondary to constipation or impaction and neurogenic incontinence were equally common. Full compliance with the recommended treatment was obtained in 66%, and 87% of these were cured. This compared with 32% of the control group during the same period (P less than 0.001). This study confirms that in the great majority of cases faecal incontinence in old people is both curable and preventable.

Treatment of urinary incontinence in the elderly.

The most common and most difficult type of urinary incontinence in older people is associated with a low-capacity neurogenic bladder. Patients with cerebrovascular disease are particularly affected. A basic consideration in treatment is provision of adequate facilities for the patient to empty his bladder regularly and quickly. Regulation of fluid intake and use of various drugs may be beneficial. An indwelling catheter may be the best alternative for intractable incontinence, even with the hazard of inevitable infection.

Urinary Incontinence in Old People

Urinary Incontinence in Old People

Incontinence in Old People

Incontinence in Old People

Incontinence in Old People

Incontinence in Old People

Incontinence in Old People.

Incontinence in Old People.

Incontinence in Old People

Incontinence in Old People