Urinary incontinence in women 55 years and older: A scoping review to understand prevalence, incidence, and mortality of urinary incontinence during secondary care admission

Abstract

Background: Up to 40% of older women living in the community experience urinary incontinence. In community settings, urinary incontinence impacts the quality of life, morbidity, and mortality rates. However, little is known about urinary incontinence and its impact on older women admitted to hospitals. Objectives: This scoping review aims to establish the current knowledge of urinary incontinence during hospital admission for women (⩾ 55 years of age) with three key objectives: (a) What is the prevalence/incidence of urinary incontinence? (b) What health conditions are associated with urinary incontinence? (c) Is there an association between urinary incontinence and mortality? Eligibility criteria: Empirical studies were included in assessing the incidence/prevalence of urinary incontinence during hospital admissions and its related morbidities and mortality rates. Studies which only included men or younger women (< 55 years of age) were excluded. Only articles written in English and conducted between 2015 and 2021 were included. Sources of evidence: A search strategy was developed, and CINAHL, MEDLINE, and Cochrane databases were searched. Charting methods: Data from each article meeting the criteria were pulled into a table, including study design, study population, and setting, aims, methods, outcome measures, and significant findings. A second researcher then reviewed the populated data extraction table. Results: Overall, 383 papers were found: 7 met inclusion/exclusion criteria. Prevalence rates ranged from 22% to 80% depending on the study cohort. Several conditions were associated with urinary incontinence, including frailty, orthopaedics, stroke, palliative care, neurology, and cardiology. There was a potential positive association between mortality and urinary incontinence, although only two papers reviewed reported mortality. Conclusion: A dearth of literature determined the prevalence, incidence, and mortality rates for older women admitted to hospitals. Limited consensus on associated conditions was found. Further research is needed to fully explore urinary incontinence in older women during hospital admissions, particularly concerning prevalence/incidence and its association with mortality.

Dialysis for older adults: why should the targets be different?

“…The KDOQI clinical guidelines do recommend that less than the standard thrice weekly 4-h dialysis sessions can be offered to patients with residual renal urea clearance > 3 mL/ min/1.73 m 2 . However, elderly frail patients are less likely to be able to accurately carry out 24-h urine collections due to immobility, incontinence, and dementia [24,25], and even if urine can be collected, residual renal urea clearance simply reflects glomerular clearance. While combining urea and creatinine clearance more closely resembles inulin clearance, the benefits of residual kidney function may not solely be due to glomerular filtration but might also reside with renal tubular secretion of protein-bound uraemic toxins and clearance of middle molecules.…”