Risk factors for the development of fecal and urinary incontinence in Wisconsin nursing home residents

Urinary incontinence (UI) is a common problem among older adults. This study investigated the prevalence of UI in nursing home residents aged ≥75 years in China and examined potential risk factors associated with UI and its subtypes. Data were collected during face-to-face interviews using a general questionnaire, the International Consultation Incontinence Questionnaire Short-Form, and the Barthel Index. A total of 551 participants aged ≥75 years residing in Changsha city were enrolled from June to December 2018. The UI prevalence rate among nursing home residents aged ≥75 years was 24.3%. The most frequent subtype was mixed (M) UI (38.1%), followed by urge (U) UI (35.1%), stress (S) UI (11.9%), and other types (14.9%). In terms of severity, 57.5% had moderate UI, while 35.1% had mild and 7.5% had severe UI. Constipation, immobility, wheelchair use, cardiovascular disease (CVD), and pelvic or spinal surgery were significant risk factors for UI. Participants with a history of surgery had higher risks of SUI (odds ratio [OR] = 4.87, 95% confidence interval [CI]: 1.55–15.30) and UUI (OR = 1.97, 95% CI: 1.05–3.71), those who were immobile or used a wheelchair had higher rates of MUI (OR = 11.07, 95% CI: 4.19–29.28; OR = 3.36, 95% CI: 1.16–9.78) and other UI types (OR = 7.89, 95% CI: 1.99–31.30; OR = 14.90, 95% CI: 4.88–45.50), those with CVD had a higher rate of UUI (OR = 2.25, 95% CI: 1.17–4.34), and those with diabetes had a higher risk of UUI (OR = 2.250, 95% CI: 1.14–4.44). Use of oral antithrombotic agents increased UUI risk (OR = 4.98, 95% CI: 2.10–11.85) whereas sedative hypnotic drug use was associated with a higher risk of MUI (OR = 3.62, 95% CI: 1.25–10.45). Each UI subtype has distinct risk factors, and elderly residents of nursing homes with a history of CVD and pelvic or spinal surgery who experience constipation should be closely monitored. Reducing time spent in bed and engaging in active rehabilitation including walking and muscle strengthening may aid in UI prevention and treatment.

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Prevalence of urinary incontinence and associated risk factors in nursing home residents: A systematic review

Neurourology and Urodynamics ◽

10.1002/nau.20668 ◽

2009 ◽

Vol 28 (4) ◽

pp. 288-294 ◽

Cited By ~ 119

Author(s):

May P.W. Offermans ◽

Monique F.M.T. Du Moulin ◽

Jan P.H. Hamers ◽

Theo Dassen ◽

Ruud J.G. Halfens

Keyword(s):

Risk Factors ◽

Systematic Review ◽

Urinary Incontinence ◽

Nursing Home ◽

Nursing Home Residents ◽

Associated Risk Factors

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Incidence of falls in the elderly population

Medicinski pregled ◽

10.2298/mpns1710277p ◽

2017 ◽

Vol 70 (9-10) ◽

pp. 277-282

Author(s):

Jelena Pavlovic ◽

Maja Racic ◽

Divna Kekus ◽

Mile Despotovic ◽

Sandra Jokovic ◽

...

Keyword(s):

Risk Factors ◽

Urinary Incontinence ◽

Nursing Home ◽

Activities Of Daily Living ◽

Elderly People ◽

Daily Living ◽

Nursing Home Residents ◽

Community Dwelling ◽

Significant Difference ◽

Risk Factors For Falls

Introduction. Falls and fall-related injuries are common in the geriatric population and may be associated with significant morbidity and mortality. The aim of this study was to determine differences in the incidence of falls and risk factors for falls between the community-dwelling and institutionalized elderly people. Material and Methods. The cross sectional study was conducted in the period from May 1, 2015 to December 1, 2015, including 300 community-dwelling elderly people and 110 nursing home residents. The research instruments were a sociodemographic questionnaire, Mini nutritional assessment, Katz index, and Lawton scale. Results. During the previous 12 months, at least one fall was reported in 17.1% of the total number of respondents. The incidence of falls was higher among nursing home residents (c2 = 13.550; p = 0.001). The risk factors for falls were multifactorial. Community-dwelling elderly suffered from urinary incontinence more frequently compared to nursing home residents (p = 0.004), but a significantly worse nutritional status was found in community-dwelling elderly people (p < 0.001). Assistance in basic activities of daily living was required by 3.9% of nursing home residents, and 8.3% of community-dwelling elderly people (p < 0.001). Statistically significant difference was not found in the performance of instrumental activities of daily living (p < 0.145). Conclusion. The incidence of falls was higher in nursing home residents. Risk factors for falls in both examined groups were visual and hearing impairments, urinary incontinence, use of 3 medications per day, damaged functional status, and malnutrition. Prevention of falls requires modification of environmental hazards, reduction of risk factors, their evaluation and strategy implementation.

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Advanced cognitive impairment among older nursing home residents

BMC Geriatrics ◽

10.1186/s12877-021-02336-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Tadeja Gracner ◽

Patricia W. Stone ◽

Mansi Agarwal ◽

Mark Sorbero ◽

Susan L Mitchell ◽

...

Keyword(s):

Risk Factors ◽

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Nursing Home ◽

Cognitive Impairment ◽

Mortality Risk ◽

Advanced Disease ◽

Nursing Home Residents ◽

Functional Score ◽

Data Set

Abstract Background Though work has been done studying nursing home (NH) residents with either advanced Alzheimer’s disease (AD) or Alzheimer’s disease related dementia (ADRD), none have distinguished between them; even though their clinical features affecting survival are different. In this study, we compared mortality risk factors and survival between NH residents with advanced AD and those with advanced ADRD. Methods This is a retrospective observational study, in which we examined a sample of 34,493 U.S. NH residents aged 65 and over in the Minimum Data Set (2011–2013). Incident assessment of advanced disease was defined as the first MDS assessment with severe cognitive impairment (Cognitive Functional Score equals to 4) and diagnoses of AD or ADRD. Demographics, functional limitations, and comorbidities were evaluated as mortality risk factors using Cox models. Survival was characterized with Kaplan-Maier functions. Results Of those with advanced cognitive impairment, 35 % had AD and 65 % ADRD. At the incident assessment of advanced disease, those with AD had better health compared to those with ADRD. Mortality risk factors were similar between groups (shortness of breath, difficulties eating, substantial weight-loss, diabetes mellitus, heart failure, chronic obstructive pulmonary disease, and pneumonia; all p < 0.01). However, stroke and difficulty with transfer (for women) were significant mortality risk factors only for those with advanced AD. Urinary tract infection, and hypertension (for women) only were mortality risk factors for those with advanced ADRD. Median survival was significantly shorter for the advanced ADRD group (194 days) compared to the advanced AD group (300 days). Conclusions There were distinct mortality and survival patterns of NH residents with advanced AD and ADRD. This may help with care planning decisions regarding therapeutic and palliative care.

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