Urinary incontinence in older adults: what you need to know

2021 ◽  
pp. 1-8
Author(s):  
Krishma Kataria ◽  
Amy Ilsley
Keyword(s):  
Older Adults ◽  
Surgical Management ◽  
Fluid Intake ◽  
Positive Impact ◽  
External Genitalia ◽  
Medical Professional ◽  
Careful Consideration ◽  
Geriatric Syndrome ◽  
Form Part ◽  
Basic Examination

Incontinence is a problem that can affect individuals of all ages. However, it is more frequently seen in older adults. It is a common geriatric syndrome, and its investigation should form part of a comprehensive geriatric assessment. Continence problems are usually ignored by patients and not reported to a medical professional, but with simple assessment and even simpler interventions, a significant improvement can be made for those living with incontinence. Most cases need a simple clinical assessment consisting of a good history and basic examination covering the abdomen, external genitalia and rectum. If no reversible causes are found, further investigations can be considered. The treatment for incontinence can be split into non-surgical and surgical management. Simple conservative measures, such as education around fluid intake, weight loss, managing constipation and pelvic floor exercises, can make a huge and positive impact on managing incontinence. If these are not effective, pharmaceutical therapies and surgical management can be considered, but there needs to be a careful consideration of the risk vs benefit in frail older adults.

scholarly journals Functional Constipation and Anorexia in Community-Dwelling Older Adults: Korean Frailty and Aging Cohort Study (KFACS)

2021 ◽  
Vol 18 (11) ◽  
pp. 5754
Author(s):  
Eunjin Jeong ◽  
Jung A Kim ◽  
Byung Sung Kim ◽  
Chang Kyun Lee ◽  
Miji Kim ◽  
...  
Keyword(s):  
Older Adults ◽  
Cohort Study ◽  
Depressed Mood ◽  
Mmse Score ◽  
Univariate Analysis ◽  
Functional Constipation ◽  
Community Dwelling ◽  
Geriatric Syndrome ◽  
Female Sex ◽  
Community Dwelling Older Adults

Anorexia is a relevant geriatric syndrome because it accounts for most malnutrition in older adults. Constipation has been suggested as a risk factor for anorexia. This study aimed to examine the association between anorexia and functional constipation in community-dwelling older adults. Data on 899 subjects aged 72–86 years were obtained from a follow-up survey of the Korean Frailty and Aging Cohort Study in 2018. Anorexia was assessed using the Simplified Nutritional Appetite Questionnaire (SNAQ), while functional constipation was diagnosed based on Rome IV criteria. Anorexia and functional constipation were present in 30.9% and 19.6% of the participants, respectively. Age, female sex, chewing problems, malnutrition, polypharmacy, low Mini-Mental Status Examination (MMSE) score, depressed mood, low serum albumin, and functional constipation were associated with anorexia in the univariate analysis. In the multivariate logistic regression, functional constipation was associated with anorexia (OR 1.478, 95% CI 1.038–2.104) after adjusting for age, female sex, and MMSE score. However, after further adjusting for depressed mood (OR 2.568) and chewing problems (OR 2.196), the relationship was no longer significant. This study showed that functional constipation is associated with anorexia in community-dwelling older adults, but this association is confounded by depressed mood and chewing problems.

scholarly journals Frailty transitions and cognitive function among South Korean older adults

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Fatima Nari ◽  
Bich Na Jang ◽  
Hin Moi Youn ◽  
Wonjeong Jeong ◽  
Sung-In Jang ◽  
...  
Keyword(s):  
Older Adults ◽  
Cognitive Function ◽  
Daily Living ◽  
Mini Mental State Examination ◽  
Adult Population ◽  
Geriatric Syndrome ◽  
South Korean ◽  
Adl Disability ◽  
Older Adult Population ◽  
State Examination

AbstractFrailty is considered a multidimensional geriatric syndrome, manifested by the accumulation of age-associated deficits. The consequences of frailty transitions are still understudied. This study evaluated the influence of frailty transitions on cognitive function in the older adult population. We used data derived from the Korean Longitudinal Study of Aging (KLoSA) (2008–2018) on older adults aged ≥ 65 years. Frailty was assessed using a validated Korean frailty measure known as the frailty instrument (FI), and cognitive function was measured using the Korean version of the Mini-Mental State Examination (K-MMSE). Transitions in frailty and their relationship with cognitive function were investigated using lagged generalized estimating equations (GEE), t-tests, and ANOVA. Respondents who experienced frailty transitions (those with ameliorating frailty), those who developed frailty, and whose frailty remained constant, were more likely to have a lower cognitive function than those who were consistently non-frail. Older age, activities of daily living (ADL) disability, and instrumental ADL disability were more negatively associated with declining cognitive function, especially in the “frail → frail” group. Changes in all individual components of the frailty instrument were significantly associated with impaired cognitive function. The results suggest an association between frailty transitions and cognitive impairment. Over a 2-year span, the remaining frail individuals had the highest rate of cognitive decline in men, while the change from non-frail to frail state in women was significantly associated with the lowest cognitive function values. We recommend early interventions and prevention strategies in older adults to help ameliorate or slow down both frailty and cognitive function decline.

scholarly journals Association between Phthalate Exposure and Frailty among Community-Dwelling Older Adults: A Repeated Panel Data Study

2021 ◽  
Vol 18 (4) ◽  
pp. 1985
Author(s):  
Hongsoo Kim ◽  
Seyune Lee ◽  
Young-Il Jung ◽  
Yun-Chul Hong
Keyword(s):  
Older Adults ◽  
Panel Data ◽  
Positive Impact ◽  
Environmental Pollutants ◽  
Community Dwelling ◽  
Metabolite Concentrations ◽  
Males And Females ◽  
Korean Elderly ◽  
Community Dwelling Older Adults ◽  
Ethylhexyl Phthalate

Only a few studies have examined the impacts of environmental exposure on frailty. This study investigated the association between phthalates and frailty among community-dwelling older adults. The Korean Elderly Environmental Panel II (KEEP II) study is a repeated panel data study of 800 community-dwelling older adults in South Korea. Frailty was measured with five items defined by Fried and colleagues. Environmental pollutants in the form of two types of metabolites for Di-ethylhexyl phthalate (DEHPs)—Mono (2-ethyl-5-hydroxyhexyl) phthalate (MEHHP) and Mono (2-ethyl-5-oxohexyl) phthalate (MEOHP)—were obtained from urine specimens. Analyses were performed using repeated linear mixed models. The concentration levels of both MEOHP and MEHHP in urine were significantly higher in the pre-frail or frail group than its counterparts. While adjusting for covariates, MEOHP level was positively associated with the likelihood of being pre-frail or frail in both males and females; the concentration level of MEHHP also had a positive impact on the likelihood of being pre-frail or frail in females. The DEHP metabolite concentrations were significantly lower among adults with daily fruit consumption in both males and females. DEHPs, measured by metabolite concentrations, may increase the risk of frailty among older men and women; further studies are necessary. The preventive effects of nutrition on DEHP risk should also be further investigated.

scholarly journals Food Insecurity in the United States: Identification, Treatment, and Implications

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 772-773
Author(s):  
Rose Ann DiMaria-Ghalili ◽  
Connie Bales ◽  
Julie Locher
Keyword(s):  
United States ◽  
Older Adults ◽  
At Risk ◽  
Food Insecurity ◽  
Well Being ◽  
The United States ◽  
Health Clinic ◽  
High Risk Population ◽  
Geriatric Syndrome ◽  
The Impact

Abstract Food insecurity is an under-recognized geriatric syndrome that has extensive implications in the overall health and well-being of older adults. Understanding the impact of food insecurity in older adults is a first step in identifying at-risk populations and provides a framework for potential interventions in both hospital and community-based settings. This symposium will provide an overview of current prevalence rates of food insecurity using large population-based datasets. We will present a summary indicator that expands measurement to include the functional and social support limitations (e.g., community disability, social isolation, frailty, and being homebound), which disproportionately impact older adults, and in turn their rate and experience of food insecurity and inadequate food access. We will illustrate using an example of at-risk seniors the association between sarcopenia, the age-related loss of muscle mass and function, with rates of food security in the United States. The translational aspect of the symposium will then focus on identification of psychosocial and environmental risk factors including food insecurity in older veterans preparing for surgery within the Veterans Affairs Perioperative Optimization of Senior Health clinic. Gaining insights into the importance of food insecurity will lay the foundation for an intervention for food insecurity in the deep south. Our discussant will provide an overview of the implications of these results from a public health standpoint. By highlighting the importance of food insecurity, such data can potentially become a framework to allow policy makers to expand nutritional programs as a line of defense against hunger in this high-risk population.

scholarly journals The Translation and Cross-Cultural Adaptation of an Arabic Version of the Reminiscence Functions Scale

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 343-343
Author(s):  
Abdallah Abu Khait ◽  
Juliette Shellman
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Positive Impact ◽  
Well Being ◽  
Arab Countries ◽  
Lessons Learned ◽  
Arabic Version ◽  
Harmonization Process ◽  
Back Translation ◽  
Target Culture

Abstract The Reminiscence Functions Scale (RFS), a 43 item reliable and valid scale, measures eight specific reasons as to why individuals reminisce: (a) identity (b) death preparation; (c) problem-solving; (d) bitterness revival; (e) boredom reduction; (f) intimacy maintenance; (g) conversation; and (h) teach/Inform others. Research indicates that certain reminiscence functions have a positive impact on the mental-health and well-being of older adults. However, no known studies have been conducted in Arab countries examining the relationship between reminiscence functions and mental health outcomes due to the lack of an Arabic version of the RFS. The purpose of this study was to translate the RFS from English to Arabic (Modern Standard Arabic), back-translate from Arabic to English, and compare the two English versions for equivalence and accuracy through a multi-step translation method. A team of bilingual, bicultural, Arabic speaking experts assembled to conduct the forward, back translation and harmonization process. In the next step, professionals with expertise in linguistics communication sciences and disorders, Arabic literature, geriatric nursing, and medicine reviewed the translated documents to assess the content (relevant to the target culture) and semantic equivalencies (similarity of meaning in the target culture). Challenges that occurred during the study included finding nuanced translation equivalences for Likert scale responses, translation of idioms such as “when time is heavy on my hands”, and logistical issues such as coordinating virtual meetings for the team of experts. Lessons learned during the translation process and implications for use of the RFS-Arabic version with Jordanian older adults will be presented.

scholarly journals Recent advances in non-surgical management of cancer in the elderly

F1000Research ◽  
2018 ◽  
Vol 7 ◽  
pp. 1793
Author(s):  
Emily J. Guerard ◽  
Gil E. Harmon ◽  
Kieran D. Sahasrabudhe ◽  
Noelle K. LoConte
Keyword(s):  
Older Adults ◽  
Palliative Care ◽  
Supportive Care ◽  
Medical Care ◽  
Surgical Management ◽  
The Elderly ◽  
The Body ◽  
The Other ◽  
Patients With Cancer ◽  
Chemotherapy Agents

This article summarizes the seminal publications from mid-2016 through 2017 in the area of medical care for older adults with cancer. Areas addressed include chemotherapy tolerance and efficacy in the aged, geriatric fitness assessments, and advancements in palliative and supportive care. The practice-changing finding from this past year’s publications is that antipsychotics should not be used in the management of terminal delirium in older adults receiving palliative care. The other trials demonstrated an improved understanding of the utility of geriatric assessments in patients with cancer, developed the body of information about which chemotherapy agents are safe and effective in older adults (and which are not), and expanded our understanding of good palliative and supportive care.

scholarly journals Aging clinical problems: a difficult balance between age and frailty

2016 ◽  
Vol 84 (1-2) ◽  
Author(s):  
Renzo Rozzini
Keyword(s):  
Public Health ◽  
Older Adults ◽  
Weight Loss ◽  
Elevated Risk ◽  
Geriatric Syndrome ◽  
Central Focus ◽  
Health Practitioners ◽  
And Function ◽  
Public Health Practitioners ◽  
Clinical Problems

<p>Frailty is a common geriatric syndrome that embodies an elevated risk of catastrophic declines in health and function among older adults. Frailty is a condition associated with ageing with associated weakness, slowing, decreased energy, lower activity, and, when severe, unintended weight loss. As a population ages, a central focus of geriatricians and public health practitioners is to understand, and then beneficially intervene on, the factors and processes that put elders at such risk, especially the increased vulnerability to stressors (e.g. extremes of heat and cold, infection, injury, or even changes in medication) that characterizes many older adults. The syndrome of geriatric frailty is hypothesized to reflect impairments in the regulation of multiple physiologic systems, embodying a lack of resilience to physiologic challenges and thus elevated risk for a range of deleterious endpoints. The empirical assessment of geriatric frailty in individuals seeks to capture this or related features.</p><p><strong>Riassunto</strong></p><p>Fragilità è la predisposizione alla rottura, al danno. L’etimologia della parola fragilità da "frango", rompere, rimanda alla nozione di qualche cosa che se sottoposto a una pressione, a un impatto, rischia di danneggiarsi facilmente. E’ dunque una nozione ampia e intuitiva che può avere ambiti di precisazione più diversi a seconda che se ne parli in fisica (dove esistono dei coefficienti esatti) piuttosto che nei campi della morale o del sentimento, dove la valutazione sarà sempre più "poetica" e affidata alla sensibilità individuale.</p>

scholarly journals Aging Back Clinics—a Geriatric Syndrome Approach to Treating Chronic Low Back Pain in Older Adults: Results of a Preliminary Randomized Controlled Trial

Pain Medicine ◽  
2019 ◽  
Author(s):  
Debra K Weiner ◽  
Angela Gentili ◽  
Michelle Rossi ◽  
Katherine Coffey-Vega ◽  
Keri L Rodriguez ◽  
...  
Keyword(s):  
Older Adults ◽  
Randomized Controlled Trial ◽  
Low Back Pain ◽  
Back Pain ◽  
Chronic Low Back Pain ◽  
Controlled Trial ◽  
Care Utilization ◽  
Geriatric Syndrome ◽  
Low Back ◽  
Randomized Controlled

Abstract Objective Treating chronic low back pain (CLBP) with spine-focused interventions is common, potentially dangerous, and often ineffective. This preliminary trial tests the feasibility and efficacy of caring for CLBP in older adults as a geriatric syndrome in Aging Back Clinics (ABC). Design Randomized controlled trial. Setting Outpatient clinics of two VA Medical Centers. Subjects Fifty-five English-speaking veterans aged 60–89 with CLBP and no red flags for serious underlying illness, prior back surgery, dementia, impaired communication, or uncontrolled psychiatric illness. Methods Participants were randomized to ABC care or usual care (UC) and followed for six months. ABC care included 1) a structured history and physical examination to identify pain contributors, 2) structured participant education, 3) collaborative decision-making, and 4) care guided by condition-specific algorithms. Primary outcomes were low back pain severity (0–10 current and seven-day average/worst pain) and pain-related disability (Roland Morris). Secondary outcomes included the SF-12 and health care utilization. Results ABC participants experienced significantly greater reduction in seven-day average (–1.22 points, P = 0.023) and worst pain (–1.70 points, P = 0.003) and SF-12 interference with social activities (50.0 vs 11.5%, P = 0.0030) at six months. ABC participants were less likely to take muscle relaxants (16.7 vs 42.3%, P = 0.0481). Descriptively, UC participants were more likely to experience pain-related emergency room visits (45.8% vs 30.8%) and to be exposed to non-COX2 nonsteroidal anti-inflammatory drugs (73.1% vs 54.2%). Conclusions These preliminary data suggest that ABC care for older veterans with CLBP is feasible and may reduce pain and exposure to other potential morbidity.

scholarly journals Epidemiology of burn injury in older adults: An Australian and New Zealand perspective

2020 ◽  
Vol 6 ◽  
pp. 205951312095233
Author(s):  
Lincoln M Tracy ◽  
Yvonne Singer ◽  
Rebecca Schrale ◽  
Jennifer Gong ◽  
Anne Darton ◽  
...  
Keyword(s):  
Older Adults ◽  
New Zealand ◽  
Older Adult ◽  
Surgical Management ◽  
Surgical Procedure ◽  
Burn Injury ◽  
Burn Injuries ◽  
Younger Patients ◽  
Care Community ◽  
Burn Care

Introduction: The ageing global population presents a novel set of challenges for trauma systems. Less research has focused on the older adult population with burns and how they differ compared to younger patients. This study aimed to describe, and compare with younger peers, the number, causes and surgical management of older adults with burn injuries in Australia and New Zealand. Methods: The Burns Registry of Australia and New Zealand was used to identify patients with burn injuries between 1 July 2009 and 31 December 2018. Temporal trends in incidence rates were evaluated and categorised by age at injury. Patient demographics, injury severity and event characteristics, surgical intervention and in-hospital outcomes were investigated. Results: There were 2394 burn-injured older adults admitted during the study period, accounting for 13.4% of adult admissions. Scalds were the most common cause of burn injury in older adults. The incidence of older adult burns increased by 2.96% each year (incidence rate ratio = 1.030, 95% confidence interval = 1.013–1.046, P < 0.001). Compared to their younger peers, a smaller proportion of older adult patients were taken to theatre for a surgical procedure, though a larger proportion of older adults received a skin graft. Discussion: Differences in patient and injury characteristics, surgical management and in-hospital outcomes were observed for older adults. These findings provide the Australian and New Zealand burn care community with a greater understanding of burn injury and their treatments in a unique group of patients who are at risk of poorer outcomes than younger people. Lay Summary The number and proportion of older persons in every country of the world is growing. This may create challenges for healthcare systems. While burn injuries are a unique subset of trauma that affect individuals of all ages, less is known about burns in older adults and how they differ from younger patients. We wanted to look at the number, type, management, and outcomes of burns in older adults in Australia and New Zealand. To do this, we used data from the Burns Registry of Australia and New Zealand, or BRANZ. The BRANZ is a database that collects information on patients that present to Australian and New Zealand hospitals that have a specialist burns unit. Our research found that one in eight adult burns patients was over the age of 65, and that the rate of burn injuries in older adults has increased over the last decade. Older adult burns patients were most commonly affected by scalds after coming in contact with wet heat such as boiling liquids or steam. Fewer older adults went to theatre for an operation or surgical procedure compared to their younger counterparts. However, a larger proportion of older adults that went to theatre had a skin graft (where skin is removed from an uninjured part of the body and placed over the injured part). This research provides important information about a unique and growing group of patients to the local burn care community. It also highlights potential avenues for injury prevention initiatives.

“It’s My Time”: Older Adults’ Experiences and Perceived Benefits of Participation in an Intergenerational Rock Band

2019 ◽  
Vol 38 (2) ◽  
pp. 187-194
Author(s):  
Natalie Wlodarczyk
Keyword(s):  
Older Adults ◽  
Older Adult ◽  
Positive Impact ◽  
Qualitative Content Analysis ◽  
Perceived Benefits ◽  
Structured Interviews ◽  
Rock Band ◽  
Ability Levels ◽  
Free Environment ◽  
First Time

Abstract The purpose of this qualitative content analysis was to explore the experiences and perceived benefits for older adult members who participated in an intergenerational rock band (IGRB) pairing older adults with college students. Participants (n = 29) were first-time older adult IGRB members who completed semi-structured interviews over the course of 5 years. Interviews were completed within 1 week of the conclusion of the semester-long participation in the IGRB. Each interview was digitally recorded, manually transcribed, and analyzed using an iterative approach to thematic analysis. Experiences and perceived benefits associated with participation in the IGRB for these older adults were encompassed by four themes: Staying Active, Wanting to Try Something New, Feeling Connected, and Seeking Positive Experiences. Findings indicate that an IGRB is an innovative, collaborative, and inclusive intergenerational music-making experience that leaves a multifaceted and overall positive impact on its older adult members. Themes suggest that older adults with musical backgrounds may enjoy an experience like an IGRB because it brings a level of familiarity coupled with the opportunity to try something new and different from their previous experiences with music. A key contribution of this study is the importance of promoting a judgment-free environment for singing that is inclusive of all ability levels. Developing a better understanding of older adults’ motivations for participating in an IGRB may help us to plan future music experiences for older adults and broaden our reach to the older adult community.

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