The Management of Urinary Incontinence in Residential and Nursing Homes for Older People

SummaryUrinary incontinence is a common problem, more so in older people and those in residential or nursing homes. Guidelines promote a structure to the management of incontinence, recommending non-pharmacological measures (including continence aids) as first-line options. Anticholinergic medications are used widely for urge incontinence, and surgical measures employed in selective cases.Whilst other treatments are being tried, or where incontinence is refractory to treatment (about 30% of cases), it is important to promote continence or contain incontinence with continence aids in order to minimize psychological complications. What can be a bewildering array of aids is available and choosing the right type of aid requires knowledge of these. Here, we suggest a classification of continence aids, describing individual characteristics and appropriate situations for use.

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Sarcopenia and Associated Factors According to the EWGSOP2 Criteria in Older People Living in Nursing Homes: A Cross-Sectional Study

10.21203/rs.3.rs-957988/v1 ◽

2021 ◽

Author(s):

Anna Escribà-Salvans ◽

Javier Jerez-Roig ◽

Miriam Molas-Tuneu ◽

Pau Farrés-Godayol ◽

Pau Moreno-Martin ◽

...

Keyword(s):

Urinary Incontinence ◽

Nursing Homes ◽

Older People ◽

Sedentary Behavior ◽

Associated Factors ◽

Protective Factor ◽

Cross Sectional ◽

European Working ◽

Original Definition ◽

Associate Factor

Abstract Background: In 2018, the European Working Group on Sarcopenia in Older People (EWGSOP2) updated the original definition of sarcopenia, establishing new criteria to be used globally. To our knowledge, this is the first study considering it for the diagnosis of sarcopenia in older people living in Nursing Homes.Aim: Verify the prevalence and the degree of severity of sarcopenia according to the new EWSGOP2 criteria and to analyse its associated factors in residents living in nursing homes from Central Catalonia (Spain).Design: A cross-sectional multicenter study was conducted in 4 nursing homes. SARC-F test was applied as the initial screening, muscle strength was measured by a dynamometer, skeletal muscle mass by bioimpedance analysis and physical performance by Gait Speed. Four categories were used: total probable sarcopenia, probable sarcopenia, confirmed sarcopenia and severe sarcopenia.Results: Among the total sample of 104 nursing home residents (mean age 84.6, ± 7.8), and 84.6% women), 85 (81.7%) (95% confidence interval [CI], 73.0-88.0) had total probable sarcopenia, 63 (60.5%) had probable sarcopenia, 19 (18.3%) confirmed sarcopenia and 7 (6.7%) severe sarcopenia. In the bivariate analysis, obesity was negatively associated and total time in sedentary behavior positively associated with all sarcopenia categories. In addition, malnutrition was positively associated with total and probable sarcopenia. Urinary incontinence was a positive associated factor of total and probable sarcopenia. In the multivariate analysis, obesity represented a negative associate factor: OR=0.13 (0.03 - 0.57), p=0.007 and OR=0.14 (0.03 - 0.60), p=0.008 with total and probable sarcopenia, respectively, adjusted by urinary incontinence. For confirmed sarcopenia, obesity also represented a negative associate factor OR=0.06 (0.01 - 0.99), p=0.049 and the total time in sedentary behavior a positive associate factor OR=1.10 (1.00- 1.20), p=0.040. Conclusions: According the EWGSOP2 criteria, high prevalence of sarcopenia was found in institutionalized older people, ranging from 6.7% to 81.7% depending on the category. Malnutrition, urinary incontinence and total time in sedentary behavior were associated with sarcopenia whilst obesity represented a protective factor in this population.

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