Report and Research Agenda of the American Geriatrics Society and National Institute on Aging Bedside‐to‐Bench Conference on Urinary Incontinence in Older Adults: A Translational Research Agenda for a Complex Geriatric Syndrome

Vaughan, Camille P.; Markland, Alayne D.; Smith, Phillip P.; Burgio, Kathryn L.; Kuchel, George A.; Faculty,

doi:10.1111/jgs.15157

Cited by 40 publications

(31 citation statements)

References 115 publications

(119 reference statements)

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“…Urinary incontinence (UI) is considered a geriatric syndrome, and is associated with multiple health‐related problems, including dermatitis, falls, lower activity of daily living (ADL), impairment of dignity and higher mortality . The prevalence of double incontinence (DI), both UI and fecal incontinence (FI), is high among individuals living in nursing homes, and the significant predictors for the development of DI are pre‐existing UI, greater functional or cognitive impairment, higher number of comorbidities, older age and lower quality of nursing home care .…”

Section: Introductionmentioning

confidence: 99%

Nationwide survey of continence status among older adult residents living in long‐term care facilities in Japan: The prevalence and associated risk factors of incontinence and effect of comprehensive care on continence status

Suzuki

Okochi²,

Iijima

et al. 2020

Geriatrics Gerontology Int

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Aim This study aimed to identify the prevalence of urinary, fecal and double incontinence among Japanese residents aged ≥65 years living in long‐term care facilities. Furthermore, the association between baseline characteristics and changes in toileting activity after a 3‐month comprehensive care among older individuals was investigated. Methods We examined the prevalence of incontinence and its significant predictors. The association between the Functional Independence Measure score at baseline and each type of incontinence (urinary, fecal or double incontinence) was examined using a logistic regression model. Similarly, the association between the Functional Independence Measure score at baseline and improvement in toileting activity after a 3‐month comprehensive care was examined. Results In total, 2517 residents (670 men and 1847 women) were recruited. The prevalence rates of urinary, fecal and double incontinence were 66.9%, 42.8% and 41.1%, respectively. In multivariate analysis, the sum of the motor subscales after removing four continence items and the sum of the cognitive subscales of the Functional Independence Measure score at baseline were significantly associated with all types of incontinence. The sum of the motor subscales after removing four continence items of the Functional Independence Measure score was associated with improved toileting activity. Conclusions This study presented the prevalence of urinary, fecal and double incontinence among residents living in long‐term care facilities in Japan. The Functional Independence Measure items at baseline were associated with not only continence status, but also improved toileting activity after 3‐month comprehensive care. Geriatr Gerontol Int 2020; 20: 285–290.

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Section: Introductionmentioning

confidence: 99%

Nationwide survey of continence status among older adult residents living in long‐term care facilities in Japan: The prevalence and associated risk factors of incontinence and effect of comprehensive care on continence status

Suzuki

Okochi²,

Iijima

et al. 2020

Geriatrics Gerontology Int

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“…Urinary symptoms increase in prevalence with aging, directly contributing to diminished quality of life, increased economic burden, and morbidity . Annual expenditures for urinary incontinence alone rivals that of all cancer care in the United States .…”

Section: Introductionmentioning

confidence: 99%

“…Annual expenditures for urinary incontinence alone rivals that of all cancer care in the United States . Despite an urgent need, available evaluative, and therapeutic strategies for urinary symptoms are often incomplete and inadequate, with palliative catheterization or containment remaining commonplace in older adults …”

Section: Introductionmentioning

confidence: 99%

“…strategies for urinary symptoms are often incomplete and inadequate, with palliative catheterization or containment remaining commonplace in older adults. 1 The aging bladder phenotype has been attributed to age-associated changes in molecular, structural, tissue response, cystometric (reflex), and behavioral (cognitive) domains pertaining to urinary control. 4 Pharmacotherapeutics are modeled on a correspondence between molecular function and patient perceptions.…”

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confidence: 99%

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The aging bladder phenotype is not the direct consequence of bladder aging

Hardy

Keilich

Harrison

et al. 2019

Neurourology and Urodynamics

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Aims The prevalence of urinary dysfunction increases with age, yet therapies are often suboptimal. Incomplete understanding of the linkages between system, organ, and tissue domains across lifespan remains a knowledge gap. If tissue‐level changes drive the aging bladder phenotype, parallel changes should be observed across these domains. In contrast, a lack of inter‐domain correlation across age groups would support the hypothesis that urinary performance is a measure of the physiologic reserve, dependent on centrally‐mediated adaptive mechanisms in the aging system. Methods Male and female mice across four age groups underwent sequential voiding spot assays, pressure/flow cystometry, bladder strip tension studies, histology, and quantitative PCR analyses. The primary objective of this study was to test the impact of age on the cortical, autonomic, tissue functional and structural, and molecular domains, and identify inter‐domain correlations among variables showing significant changes with age within these domains. Results Behavior revealed diminished peripheral voiding and spot size in aged females. Cystometry demonstrated increased postvoid residual and loss of volume sensitivity, but the preservation of voiding contraction power, with almost half of oldest‐old mice failing under cystometric stress. Strip studies revealed no significant differences in adrenergic, cholinergic, or EFS sensitivity. Histology showed increased detrusor and lamina propria thickness, without a change in collagen/muscle ratio. Adrb2 gene expression decreased with age. No consistent inter‐domain correlations were found across age groups. Conclusions Our findings are consistent with a model in which centrally‐mediated adaptive failures to aging stressors are more influential over the aging bladder phenotype than local tissue changes.

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“…A study of people aged over 40 years reported an annual incontinence incidence rate of 6.3% . Some of the factors associated with UI in the older general population include age, frailty, falls, obesity, parity and comorbidities such as hypertension, diabetes, cognitive impairment, depression, urinary tract infection, stroke and mobility impairment …”

Section: Introductionmentioning

confidence: 99%

Assessment, incidence and factors associated with urinary incontinence in older Aboriginal Australians

Smith

Sutherland

Hyde

et al. 2019

Internal Medicine Journal

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Background:Little is known about urinary incontinence in older Aboriginal Australians.Aim: To describe urinary incontinence assessment, prevalence, incidence and associated conditions in older Aboriginal Australians.Methods: Wave 1 consisted of 363 Aboriginal participants aged ≥45 years from Western Australia; 289 participants participated in Wave 2, with 184 included at both time points. Urinary incontinence was assessed by self-report, family report and the modified International Consultation on Incontinence Questionnaire (ICIQ). We investigated factors associated with incontinence with binary logistic regression. Sensitivity and specificity analyses of incontinence measures were undertaken using the ICIQ score ≥2 as the reference standard.Results: Participant mean age was 61.2 AE 11.2 years. Prevalence of incontinence at Wave 2 (n = 289) using self-report was 24.6%; using ICIQ ≥2 was 22.5%; and family report 14.2%. Incidence after follow-up of 6.7 years was 33 (23.6%), higher than estimates of 5-20% in other populations. Cross-sectional associations with incontinence include female sex (odds ratio (OR) = 6.82; 95% confidence interval (CI) 2.98-15.57), stroke (OR = 3.55; 95% CI 1.43-8.77), head injury (OR = 3.15; 95% CI 1.54-6.45) and depressive symptoms (OR = 1.07; 95% CI 1.01-1.14). Longitudinal associations were age (OR = 1.05; 95% CI 1.01-1.09) and female sex (OR = 2.37; 95% CI 0.99-5.67). Sensitivity (81.5%) and specificity (93.5%) of self-report were high. Conclusion: The prevalence and incidence of urinary incontinence in AboriginalAustralians is high with risk factors of older age and female sex. The modified ICIQ and self-report appear to be appropriate incontinence screens. Further research to understand causes and treatments within this population is urgently required.

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Report and Research Agenda of the American Geriatrics Society and National Institute on Aging Bedside‐to‐Bench Conference on Urinary Incontinence in Older Adults: A Translational Research Agenda for a Complex Geriatric Syndrome

Cited by 40 publications

References 115 publications

Nationwide survey of continence status among older adult residents living in long‐term care facilities in Japan: The prevalence and associated risk factors of incontinence and effect of comprehensive care on continence status

Nationwide survey of continence status among older adult residents living in long‐term care facilities in Japan: The prevalence and associated risk factors of incontinence and effect of comprehensive care on continence status

The aging bladder phenotype is not the direct consequence of bladder aging

Assessment, incidence and factors associated with urinary incontinence in older Aboriginal Australians

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