Multimorbidity increased the risk of urinary incontinence in community-dwelling adults: Results from the English Longitudinal Study On Ageing

Barbagallo, Mario; Smıth, Lee; Koyanagi, Ai; Domínguez, Ligia J.; Fazzari, Anna; Marrone, Eliana; Maggi, Stefania; Ruotolo, Giovanni; Castagna, Alberto; Veronese, Nicola

doi:10.1016/j.maturitas.2022.12.007

Cited by 5 publications

(12 citation statements)

References 28 publications

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“…It is noteworthy that the averaged cross‐validated AUC = 0.634 (95% CI: 0.630, 0.638) for females and 0.630 (95% CI: 0.624, 0.634) for males in our adjusted models using multimorbidity defined by ≥2 conditions. This is slightly less that the c‐index (an equivalent measure) of 0.64 (95% CI: 0.62, 0.65) reported for English females and males combined 6 . Based on Hosmer and Lemeshow's criteria, 26 these results are defined as being predictively inadequate and suggests that other important unmeasured confounders exist.…”

Section: Discussionmentioning

confidence: 84%

“…1.82, 2.42) in younger Canadian females 14 ; and adjusted OR = 1.30 (95% CI: 1.14, 1.48) for English females and males combined. 6 While the diverse participant compositions likely explains some of these differences, multimorbidity was not rare in any of these studies. 15 Thus conventionally employed logistic regression models will produce inflated estimates.…”

Section: Discussionmentioning

confidence: 89%

“…Based on the bladder incontinence question, UI was then dichotomised into continent (complete control; response "0") and incontinent (any episodes; responses "2," "3," "4," "5") groups, as has been employed elsewhere. 6,7,14,20 Previous research supports the validity and high accuracy of self-reported UI. 21 Motivated by Ho et al 12 multimorbidity was defined to capture (where possible) their core set of 20 chronic conditions.…”

Section: Instrument and Primary Measuresmentioning

confidence: 79%

“…This is slightly less that the cindex (an equivalent measure) of 0.64 (95% CI: 0.62, 0.65) reported for English females and males combined. 6 Based on Hosmer and Lemeshow's criteria, 26 these results are defined as being predictively inadequate and suggests that other important unmeasured confounders exist. Recognizing the relatively heavier burden of multiple chronic health condition co-occurrence carried by participants within this study, two higher thresholds were also investigated.…”

Section: Discussionmentioning

confidence: 99%

“…They also acknowledge the need for consensus studies to finalize core and study-dependent conditions to include in measures of multimorbidity. 12 While recent investigations into the relationship between UI and multimorbidity have considerable strengths, 6,7,14 they also suffer from methodological shortcomings. The selection of conditions and measures employed are discordant, as could be expected in the absence of consensus studies and agreement.…”

Section: Introductionmentioning

confidence: 99%

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Multimorbidity associated with urinary incontinence among older women and men with complex needs in Aotearoa | New Zealand

Schluter,

Jamieson

2023

Neurourology and Urodynamics

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AimsTo investigate the association between multimorbidity and urinary incontinence (UI) among community living older adults with complex needs in sex‐specific crude and adjusted analyses.MethodsSince 2012 in Aotearoa | New Zealand (NZ) all community‐living older people with complex needs who require publicly funded assistance undergo a comprehensive standardized geriatric needs assessment using the interRAI‐HC instrument. Consenting adults aged ≥65 years who undertook this assessment between July 5, 2012 and December 31, 2020 were investigated. Multimorbidity was defined as having ≥2 chronic conditions. Recent bladder incontinence episodes were elicited and UI dichotomized into continent and incontinent groups.ResultsThe study included 140 401 participants with an average age of 82.0 years (range: 65–107 years), of whom 85 746 (61.1%) were female. Overall, 36 185 (42.2%) females and 17 988 (32.9%) males reported UI. Participants had a median of 3 (range: 0–12) chronic conditions, with 109 135 (77.9%) classified as having multimorbidity. In adjusted modified Poisson regression analyses, the prevalence ratio for UI was 1.21 (95% confidence interval [CI]: 1.19, 1.24) times higher in females and 1.18 (95% CI: 1.14, 1.22) times higher for males with multimorbidity compared to those without multimorbidity.ConclusionsAlthough significant, the estimated sex‐specific effect sizes were modest for the association between multimorbidity and UI in this population. However, despite using the comprehensive interRAI‐HC instrument, several potentially core chronic conditions were not adequately captured. Although increasingly recognized as an important and growing public health issue, capturing all relevant chronic conditions challenges many epidemiological investigations into multimorbidity.

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Section: Discussionmentioning

confidence: 84%

Section: Discussionmentioning

confidence: 89%

Section: Instrument and Primary Measuresmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Multimorbidity associated with urinary incontinence among older women and men with complex needs in Aotearoa | New Zealand

Schluter,

Jamieson

2023

Neurourology and Urodynamics

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Comprehensive geriatric assessment and palliative care

Castagna,

Militano,

Ruberto

et al. 2024

Aging Medicine

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The geriatric vision of palliative care is based on a multidisciplinary, patient‐centered approach, looking for a balance between human dignity and medical treatments with a particular focus on the social and ethical aspects. In order to develop the best care models, there is a rising need for a tighter collaboration of all the involved players (i.e., doctors, nurses, social workers). Indeed, the idea of a fragmented system without considering the patient or his/her family is not at all applicable to older patients with chronic disease. The causes of death, the phase of death changes, and the extend of last period of life could be a long phase characterized by complicated treatment decisions, difficult management of symptoms, multiple psychosocial problems, and complex spiritual distress. Recently, Italian guidelines on Comprehensive Geriatric Assessment (CGA) have been published. However, none of the identified studies on patients in hospice and other palliative care facilities met the criteria for inclusion. These findings underscore the need for further research to determine the potential benefits of a multidimensional approach for patients in hospice and other palliative care settings. Our reflections and suggestions on the CGA use for older persons in palliative care may be a starting point for an open and continuous dialogue with all the operators concerned.

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Dynapenic abdominal obesity and incident multimorbidity: findings from the English longitudinal study on ageing

et al. 2023

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Background Dynapenic abdominal obesity (DAO) (i.e., impairment in muscle strength and high waist circumference) is gaining interest, as it is associated with several important adverse health outcomes. However, the association between DAO and multimorbidity is largely unclear. Thus, the aim of the present study was to investigate the association between DAO at baseline and new onset multimorbidity over ten years of follow-up. Methods People participating in the English Longitudinal Study of Ageing were included. DAO was defined as waist circumference > 102 cm in men and > 88 cm in women, and a concomitant presence of dynapenia (handgrip strength defined as < 27 kg for men and < 16 kg for women). Multimorbidity was defined as having two or more chronic conditions. The association between DAO and incident multimorbidity was assessed using a multivariable logistic regression analysis, reporting the data as odds ratios (ORs) and their 95% confidence intervals (CIs). Results Overall, 3302 participants (mean age: 63.4 years, males: 50.3%) without multimorbidity at baseline were followed-up for ten years. After adjusting for several variables, compared to participants without dynapenia nor abdominal obesity, the presence of abdominal obesity (OR = 1.505; 95%CI: 1.272–1.780; p < 0.0001) and DAO (OR = 1.671; 95%CI: 1.201–2.325; p = 0.002) significantly increased the risk of multimorbidity. Compared to no dynapenia nor abdominal obesity, DAO was associated with significantly higher risk for arthritis and diabetes. Conclusions DAO was significantly associated with a higher risk of incident multimorbidity, over 10 years of follow-up. The results of our study suggest that addressing DAO can potentially decrease risk for multimorbidity.

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Multimorbidity increased the risk of urinary incontinence in community-dwelling adults: Results from the English Longitudinal Study On Ageing

Cited by 5 publications

References 28 publications

Multimorbidity associated with urinary incontinence among older women and men with complex needs in Aotearoa | New Zealand

Multimorbidity associated with urinary incontinence among older women and men with complex needs in Aotearoa | New Zealand

Comprehensive geriatric assessment and palliative care

Dynapenic abdominal obesity and incident multimorbidity: findings from the English longitudinal study on ageing

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