Urinary Incontinence and Its Association with Physical and Psycho-Cognitive Factors: A Cross-Sectional Study in Older People Living in Nursing Homes

Abstract

Urinary incontinence (UI) is a common geriatric syndrome affecting bladder health and is especially prevalent in nursing homes (NHs). The aim of the study was to determine the prevalence of UI and its associated factors in five Spanish NHs. UI (measured with Minimum Data Set 3.0.), sociodemographic, and health-related variables were collected. Chi-square (or Fisher’s) or Student’s t-test (or Mann Whitney U) for bivariate analysis were used, with Prevalence Ratio (PR) as an association measure. The prevalence of UI was 66.1% (CI:95%, 53.6–77.2) in incontinent (n = 45, mean age 84.04, SD = 7.7) and continent (n = 23, mean age 83.00, SD = 7.7) groups. UI was significantly associated with frailty (PR = 1.84; 95%CI 0.96–3.53), faecal incontinence (PR = 1.65; 95%CI 1.02–2.65), anxiety (PR = 1.64; 95%CI 1.01–2.66), physical performance (PR = 1.77; 95%CI 1.00–3.11), and cognitive state (PR = 1.95; 95%CI 1.05–3.60). Statistically significant differences were found between incontinent and continent NH residents for limitations in activities of daily living (ADL), mobility, quality of life, sedentary behaviour, and handgrip strength. It can be concluded that two out of three of the residents experienced UI, and significant associated factors were mainly physical (sedentary behaviour, frailty, physical performance, ADL limitations, mobility, faecal incontinence, and handgrip strength) followed by psycho-cognitive factors (cognition, anxiety, and quality of life).

How did the COVID‐19 pandemic affect urinary incontinence and its management in the nursing homes? A descriptive phenomenological study

“…Furthermore, pausing group activities, especially physical exercise and outdoor activities, exacerbated the development of sarcopenia, frailty, and functional decline 24 . Activity patterns can have an impact on pelvic floor health, even in NH residents, with emerging evidence on the relationship between sedentary behavior and UI 25 . In this line, a study conducted in Spain showed a significant functional, cognitive, and nutritional decline in NH residents after the first wave of the pandemic, which was attributed to the lockdown itself, because no differences were found between COVID‐19 and non‐COVID‐19 individuals 2…”

Reducing Falls in Older Women with Urinary Incontinence

“…Decline in physical performance has been associated with urinary incontinence in older women [ 40 – 42 ]. Existing literature supports a bidirectional relationship between physical function and urge urinary incontinence: worsening urinary incontinence is associated with worsening physical function including increased fall risk, and conversely, deterioration of physical function is associated with the development of urinary incontinence [ 7 , 41 – 46 ].…”

Prevalence of urinary incontinence and associated factors in nursing homes: a multicentre cross-sectional study

“…An association between urgency UI and SB bouts, defined as the accumulation of uninterrupted and prolonged SB periods, have been found in community-dwelling older women [ 20 ]. Emerging research suggests that the duration of SB bouts may have a higher impact on continence than the total amount of time spent in SB throughout the day [ 20 , 21 ]. However, there are still few studies on this topic, especially in frail older adults and NH residents.…”