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Background: Continence problems are known to be associated with disability in older adults. Costs of disability and resulting need for more supported living arrangements are high after a hip fracture. The aim was to examine pre-fracture urinary incontinence (UI) and double incontinence (DI, concurrent UI and fecal incontinence) as predictors of changes in mobility and living arrangements in older female hip fracture patients in a 1-year follow-up.

Methods: Study population comprised 1,675 female patients aged ≥ 65 (mean age 82.7 ± 6.8) sustaining their first hip fracture between 2007-2019. Data on self-reported pre-fracture continence status was collected. The outcomes were declined vs. same or improved mobility level and need for more assisted vs same or less assisted living arrangements 1-year post-fracture. Separate cohorts of 1,226 and 1,055 women were generated for the mobility and living arrangements outcomes, respectively. Age- and multivariable-adjusted logistic regression models were used to determine the associations of UI, DI, and other baseline characteristics with the outcomes.

Results: Of the patients, 39% had declined mobility or more assisted living arrangements at 1-year follow-up. Adjusting for age, both pre-fracture UI and DI were associated with changes in mobility and living arrangements. In the multivariable analysis, UI (OR 1.88, 95% CI 1.41-2.51) and DI (1.99, 95% CI 1.21-3.27) were associated with decline in mobility level while only DI (OR 2.40, 95% CI 1.22-4.75) remained associated with the need for more assisted living arrangements.

Conclusions: Both pre-fracture UI and DI in older women are risk factors for declining mobility level, but only DI for more supported living arrangements 1-year post-hip fracture. UI likely develops earlier in life and might not necessarily be strongly associated with the onset or increasing disability in later years. DI may indicate more marked vulnerability and burden to patients as well as to formal and informal caregivers.

Titel:	Do urinary and double incontinence predict changes in living arrangements and mobility in older women after hip fracture? - a 1-year prospective cohort study.
Autor/in / Beteiligte Person:	Hellman-Bronstein, AT ; Luukkaala, TH ; Ala-Nissilä, SS ; Nuotio, MS
Link:	View record at Springer (Volltext)
Zeitschrift:	BMC geriatrics, Jg. 24 (2024-01-26), Heft 1, S. 100
Veröffentlichung:	London : BioMed Central, [2001]-, 2024
Medientyp:	academicJournal
ISSN:	1471-2318 (electronic)
DOI:	10.1186/s12877-023-04637-z
Schlagwort:	Humans Female Aged Aged, 80 and over Prospective Studies Residence Characteristics Risk Factors Fecal Incontinence epidemiology Urinary Incontinence diagnosis Urinary Incontinence epidemiology Hip Fractures diagnosis Hip Fractures epidemiology
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Journal Article Language: English [BMC Geriatr] 2024 Jan 26; Vol. 24 (1), pp. 100. <i>Date of Electronic Publication: </i>2024 Jan 26. MeSH Terms: Fecal Incontinence* / epidemiology ; Urinary Incontinence* / diagnosis ; Urinary Incontinence* / epidemiology ; Hip Fractures* / diagnosis ; Hip Fractures* / epidemiology ; Humans ; Female ; Aged ; Aged, 80 and over ; Prospective Studies ; Residence Characteristics ; Risk Factors References: Int Urogynecol J. 2018 Feb;29(2):265-272. (PMID: 28620790) ; Curr Geriatr Rep. 2017 Jun;6(2):74-80. (PMID: 33214994) ; Cochrane Database Syst Rev. 2021 Nov 12;11:CD007125. (PMID: 34766330) ; Eur Geriatr Med. 2020 Aug;11(4):603-611. (PMID: 32458167) ; Neurourol Urodyn. 2017 Jan;36(1):10-34. (PMID: 27770550) ; Clin Transl Gastroenterol. 2018 Oct 25;9(10):200. (PMID: 30356052) ; J Am Med Dir Assoc. 2018 May;19(5):422-427. (PMID: 29439853) ; Value Health. 2006 Jul-Aug;9(4):272-4. (PMID: 16903997) ; J Cross Cult Gerontol. 2007 Dec;22(4):421-32. (PMID: 17763930) ; Age Ageing. 1997 Sep;26(5):367-74. (PMID: 9351481) ; J Am Med Dir Assoc. 2019 Aug;20(8):956-962.e8. (PMID: 31129021) ; Aging Clin Exp Res. 2022 Jun;34(6):1407-1418. (PMID: 34984652) ; Neurourol Urodyn. 2018 Aug;37(6):1925-1930. (PMID: 29603780) ; Obstet Gynecol. 2013 Sep;122(3):539-45. (PMID: 23921863) ; Maturitas. 2023 Jan;167:90-98. (PMID: 36327627) ; Br J Anaesth. 2014 Sep;113(3):424-32. (PMID: 24727705) ; Arch Gerontol Geriatr. 2019 May - Jun;82:226-231. (PMID: 30875524) ; J Am Geriatr Soc. 2013 Mar;61(3):371-9. (PMID: 23452034) ; Age Ageing. 2001 Nov;30(6):503-7. (PMID: 11742780) ; J Gerontol A Biol Sci Med Sci. 2003 Aug;58(8):756-62. (PMID: 12902536) ; J Gerontol A Biol Sci Med Sci. 2021 Aug 13;76(9):1600-1607. (PMID: 33963837) ; Osteoporos Int. 2016 Feb;27(2):549-58. (PMID: 26286626) ; J Orthop Surg Res. 2019 Jul 4;14(1):203. (PMID: 31272470) ; Age Ageing. 2022 Aug 2;51(8):. (PMID: 35930719) ; Med Care. 2009 Feb;47(2):191-8. (PMID: 19169120) ; Curr Geriatr Rep. 2020 Jun;9(2):64-71. (PMID: 32440467) ; Arch Gerontol Geriatr. 2015 Sep-Oct;61(2):182-9. (PMID: 26043958) ; Qual Life Res. 2000;9(10):1117-26. (PMID: 11401044) ; Neurourol Urodyn. 2018 Jan;37(1):229-236. (PMID: 28407296) ; J Am Med Dir Assoc. 2012 Nov;13(9):770-7. (PMID: 22944377) ; Injury. 2016 Jul;47(7):1536-42. (PMID: 27168083) ; J Am Geriatr Soc. 2015 May;63(5):947-53. (PMID: 25940401) ; JAMA. 2017 Oct 24;318(16):1592-1604. (PMID: 29067433) ; J Aging Health. 2019 Dec;31(10):1872-1891. (PMID: 30203699) ; Curr Opin Obstet Gynecol. 2014 Oct;26(5):393-7. (PMID: 25110978) ; Neurourol Urodyn. 2010;29(1):4-20. (PMID: 19941278) ; Neurourol Urodyn. 2019 Jun;38(5):1399-1408. (PMID: 30998290) ; J Am Geriatr Soc. 2010 Jun;58(6):1058-62. (PMID: 20487073) ; Int J Nurs Stud. 2021 Nov;123:104062. (PMID: 34461378) ; J Gerontol A Biol Sci Med Sci. 2001 Jun;56(6):M366-72. (PMID: 11382797) ; Disabil Rehabil. 2016;38(12):1125-33. (PMID: 26289373) ; Age Ageing. 2014 Mar;43(2):157-63. (PMID: 24509954) ; Neurourol Urodyn. 2018 Jan;37(1):501-509. (PMID: 28471525) ; Duodecim. 2011;127(11):1107-16. (PMID: 21755802) ; J Clin Nurs. 2007 Mar;16(3):458-68. (PMID: 17335521) ; Arch Gerontol Geriatr. 2023 Apr;107:104901. (PMID: 36521394) Contributed Indexing: Keywords: Double incontinence; Hip fracture; Institutionalization; Mobility; Urinary incontinence Entry Date(s): Date Created: 20240125 Date Completed: 20240129 Latest Revision: 20240129 Update Code: 20240129 PubMed Central ID: PMC10811924

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Do urinary and double incontinence predict changes in living arrangements and mobility in older women after hip fracture? - a 1-year prospective cohort study.