The prevalence of urinary incontinence and its relationship with physical and cognitive status in older adults: Results of the Crystal and the Eucalipt studies

BACKGROUND: Urinary incontinence worsens the psychological state of older adults, increases the risk of developing anxiety, depression, falls-related injuries, leads to a decrease in the quality of life, and a decrease in the level of physical activity in old age. AIM: To assess the prevalence of urinary incontinence according to the data of the Crystal and Eucalyptus studies, to identify factors associated with the development of urinary incontinence, as well as factors that reduce the risk of urinary incontinence in old age. MATERIALS AND METHODS: A random sample of 1007 people aged 65 and older. The main parameters: urinary incontinence, frailty, nutritional status, anemia, CRP, functional status, depression, dementia, chronic diseases, grip strength, level of physical functioning, falls. The observation time is 2.5 years. RESULTS: According to the Eucalyptus study, urinary incontinence syndrome was detected in 48.0%, in the Crystal study in 41.2%. In 62.4% cases urinary incontinence was diagnosed for the first time. Urinary incontinence was associated with a higher prevalence of COPD, history of stroke, sensory deficits, frailty and other geriatric syndromes. Improved nutrition and increased protein intake led to the disappearance of urinary incontinence complaints in 47.7% of cases. The disappearance of complaints of urinary incontinence was associated with an improvement in the emotional status. A decline in cognitive function has been associated with an increased risk of urinary incontinence in old age. CONCLUSIONS: Despite the high prevalence of urinary incontinence, it often remains undiagnosed. The correct wording of the question in the conversation with the patient allows to identify 30% more cases of urinary incontinence. Given the high prevalence of urinary incontinence among patients with COPD, stroke, sensory deficits, frailty and other geriatric syndromes, all patients in these groups should be purposefully asked about the presence of symptoms of urinary incontinence. Improved nutrition and increased protein intake are associated with the disappearance of urinary incontinence complaints.

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Vascular lesions and functional limitations among older adults: does depression make a difference?

International Psychogeriatrics ◽

10.1017/s1041610214000829 ◽

2014 ◽

Vol 26 (9) ◽

pp. 1501-1509 ◽

Cited By ~ 5

Author(s):

Celia F. Hybels ◽

Carl F. Pieper ◽

Lawrence R. Landerman ◽

Martha E. Payne ◽

David C. Steffens

Keyword(s):

Risk Factors ◽

Older Adults ◽

White Matter ◽

Functional Impairment ◽

Functional Limitations ◽

Late Life ◽

Cognitive Status ◽

Cerebral White Matter ◽

Late Life Depression ◽

Increased Risk

ABSTRACTBackground:The association between disability and depression is complex, with disability well established as a correlate and consequence of late life depression. Studies in community samples report that greater volumes of cerebral white matter hyperintensities (WMHs) seen on brain imaging are linked with functional impairment. These vascular changes are also associated with late life depression, but it is not known if depression is a modifier in the relationship between cerebrovascular changes and functional impairment.Methods:The study sample was 237 older adults diagnosed with major depression and 140 never depressed comparison adults, with both groups assessed at study enrollment. The dependent variable was the number of limitations in basic activities of daily living (ADL), instrumental ADLs, and mobility tasks. The independent variable was the total volume of cerebral white matter lesions or hyperintensities assessed though magnetic resonance imaging.Results:In analyses controlling for age, sex, race, high blood pressure, and cognitive status, a greater volume of WMH was positively associated with the total number of functional limitations as well as the number of mobility limitations among those older adults with late life depression but not among those never depressed, suggesting the association between WMH volume and functional status differs in the presence of late life depression.Conclusions:These findings suggest older patients with both depression and vascular risk factors may be at an increased risk for functional decline, and may benefit from management of both cerebrovascular risk factors and depression.

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Likelihood of Participation in Home-Based Cognitive Assessment: The Role of Subjective Cognitive Decline and Age

Innovation in Aging ◽

10.1093/geroni/igaa057.940 ◽

2020 ◽

Vol 4 (Supplement_1) ◽

pp. 293-294

Author(s):

Moriah Splonskowski ◽

Holly Cooke ◽

Claudia Jacova

Keyword(s):

Older Adults ◽

Cognitive Decline ◽

Old Age ◽

Cognitive Assessment ◽

Community Dwelling ◽

Subjective Cognitive Decline ◽

Cognitive State ◽

Home Based ◽

Increased Risk

Abstract Home-based cognitive assessment (HBCA) services are emerging as a convenient alternative to in-clinic cognitive assessment and may aid in mitigating barriers to detecting cognitive impairment (CI). It is unknown which older adults would be likely to participate in HBCA. Here we investigated the role of age and Subjective Cognitive Decline (SCD). SCD has demonstrated an increased risk for progression to CI/dementia. A nation-wide community-dwelling sample of 494 adults age 50+ were recruited via Amazon Mechanical Turk to complete an online survey assessing perceptions around HBCA and SCD. Our sample was 91.9% White and 66.8% female. It consisted of 174 respondents aged 50-60, 265 aged 61- 70, and 55 aged 71-79. Age groups were comparable with respect to their acceptance of cognitive assessment (Range 4-20, higher score=higher acceptance, 7.9±3.3, 8.15±3.2, 8.05±3.43) and SCD-Q total (43.1±5.8, 43.2±5.7, 43.3±5.7). Correlation analysis revealed a relationship between SCD-QSCD total and perceived likelihood of participation in HBCA for those ages 61-70 (r(263) = .222 p = .000), but not for ages 50-60 or 71-79 (r(172) = .102 p = .152; r(53) = -.102 p = .458). Our findings suggest that SCD influences the likelihood of participation in HBCA for older adults’ transitioning to old age (61-70). Findings show that for adults transitioning into old age (61-70), perceived cognitive state influences their likelihood of participation in HBCA. Importantly, concerns about CI/dementia may generate more favorable perceptions of HBCA for this group.

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Memory-Related Frontal Brainwaves Predict Transition to Mild Cognitive Impairment in Healthy Older Individuals Five Years Before Diagnosis

Journal of Alzheimer s Disease ◽

10.3233/jad-200931 ◽

2020 ◽

pp. 1-11

Author(s):

Yang Jiang ◽

Juan Li ◽

Frederick A. Schmitt ◽

Gregory A. Jicha ◽

Nancy B. Munro ◽

...

Keyword(s):

Older Adults ◽

Working Memory ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Memory Performance ◽

Memory Task ◽

Cognitive Status ◽

Older Individuals ◽

Increased Risk ◽

Differentiation Pattern

Background: Early prognosis of high-risk older adults for amnestic mild cognitive impairment (aMCI), using noninvasive and sensitive neuromarkers, is key for early prevention of Alzheimer’s disease. We have developed individualized measures in electrophysiological brain signals during working memory that distinguish patients with aMCI from age-matched cognitively intact older individuals. Objective: Here we test longitudinally the prognosis of the baseline neuromarkers for aMCI risk. We hypothesized that the older individuals diagnosed with incident aMCI already have aMCI-like brain signatures years before diagnosis. Methods: Electroencephalogram (EEG) and memory performance were recorded during a working memory task at baseline. The individualized baseline neuromarkers, annual cognitive status, and longitudinal changes in memory recall scores up to 10 years were analyzed. Results: Seven of the 19 cognitively normal older adults were diagnosed with incident aMCI for a median 5.2 years later. The seven converters’ frontal brainwaves were statistically identical to those patients with diagnosed aMCI (n = 14) at baseline. Importantly, the converters’ baseline memory-related brainwaves (reduced mean frontal responses to memory targets) were significantly different from those who remained normal. Furthermore, differentiation pattern of left frontal memory-related responses (targets versus nontargets) was associated with an increased risk hazard of aMCI (HR = 1.47, 95% CI 1.03, 2.08). Conclusion: The memory-related neuromarkers detect MCI-like brain signatures about five years before diagnosis. The individualized frontal neuromarkers index increased MCI risk at baseline. These noninvasive neuromarkers during our Bluegrass memory task have great potential to be used repeatedly for individualized prognosis of MCI risk and progression before clinical diagnosis.

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An audit of lithium prescribing practices in an old age psychiatry service highlighting renal impairment in this cohort

BJPsych Open ◽

10.1192/bjo.2021.323 ◽

2021 ◽

Vol 7 (S1) ◽

pp. S109-S110

Author(s):

Leia Valentine ◽

John Cannon ◽

Siobhan Marmion ◽

Michelle Corcoran ◽

Marguerite Cryan ◽

...

Keyword(s):

Older Adults ◽

Renal Function ◽

Renal Impairment ◽

Old Age ◽

Thyroid Function ◽

Serum Calcium ◽

Prescribing Practices ◽

Lithium Level ◽

Increased Risk ◽

One Year

AimsTo compare Lithium prescribing practices in a Psychiatry of Old Age (POA) Service in the North-West of Ireland among adults aged 65 years and over with best practice guidelines.MethodReview of the literature informed development of audit standards for Lithium prescribing. These included National Institute for Clinical Excellent (NICE) 2014 guidelines, The British National Formulary (2019) and Maudsley Prescribing Guidelines (2018). Data were collected retrospectively, using an audit-specific data collection tool, from clinical files of POA team caseload, aged 65 years or more and prescribed Lithium over the past one year.ResultAt the time of the audit in February 2020, 18 patients were prescribed lithium, 67% female, average age 74.6 years. Of those prescribed Lithium; 50% (n = 9) had a depression diagnosis, 44% (n = 8) had bipolar affective disorder (BPAD) and 6% (n = 1) had schizoaffective disorder.78% (n = 14) of patients were on track to meet, or had already met, the NICE standard of 3-monthly serum lithium level. Lithium levels were checked on average 4.5 times in past one year, average lithium level was 0.61mmol/L across the group and 39% (n = 7) had lithium level within recommended therapeutic range (0.6-0.8mmol/L).83% (n = 15) of patients met the NICE standards of 3 monthly renal tests, thyroid function test was performed in 89% (n = 16) and at least one serum calcium level was documented in 63% (n = 15). Taking into consideration most recent blood test results, 100% (n = 18) had abnormal renal function, 78% (n = 7) had abnormal thyroid function and 60% (n = 9) had abnormal serum calcium.Half (n = 9) were initiated on lithium by POA service and of these, 56% (n = 5) had documented renal impairment prior to initiation. Of patients on long term lithium therapy at time of referral (n = 9), almost half (n = 4) had a documented history of lithium toxicity.ConclusionThe results of this audit highlight room for improvement in lithium monitoring of older adults attending POA service. Furthermore, all patients prescribed lithium had impaired renal function, half had abnormal calcium and two fifths had abnormal thyroid function. This is an important finding given the associations between those admitted to hospital with COVID-19 and comorbid kidney disease and increased risk of inpatient death.Our findings highlight the need for three monthly renal function monitoring in older adults prescribed lithium given the additive adverse effects of increasing age and lithium on the kidney. Close working with specialised renal services to provide timely advice on renal management for those with renal impairment prescribed lithium is important to minimise adverse patient outcomes.

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Risk factors for hospitalizations (HOS) among older adults with gastrointestinal (GI) cancers receiving chemotherapy.

Journal of Clinical Oncology ◽

10.1200/jco.2017.35.15_suppl.e21523 ◽

2017 ◽

Vol 35 (15_suppl) ◽

pp. e21523-e21523

Author(s):

Daneng Li ◽

Can-Lan Sun ◽

Abrahm Levi ◽

Heidi D. Klepin ◽

Rawad Elias ◽

...

Keyword(s):

Risk Factors ◽

Older Adults ◽

Univariate Analysis ◽

Stage Iv ◽

Psychological State ◽

Cancer Type ◽

Gi Cancer ◽

Increased Risk ◽

Gi Cancers ◽

Cardiac Comorbidity

e21523 Background: Older adults undergoing chemotherapy for GI cancers are at increased risk of HOS due to treatment related toxicity; however, there are limited data regarding which individuals are at greatest risk. We therefore sought to identify risk factors for HOS among older adults with GI cancers receiving chemotherapy. Methods: We performed a secondary analysis of patients age ≥ 65 years with GI cancer who participated in either of 2 prospective studies used to develop (n = 500) and validate (n = 250) a geriatric assessment (GA) based chemotherapy toxicity score for older adults with cancer. The incidence of HOS within 30 days post treatment was determined. The following patient characteristics were captured pre-chemotherapy: demographics, cancer type, stage, laboratory values, chemotherapy type, and GA measures (functional status, comorbidity, psychological state, cognitive function, nutritional status, and social support). Univariate and multivariate logistic regressions were used to estimate the odds ratio (OR) to identify risk factors. Results: A total of 199 adults age 65+ (median 73; range 65-94) with GI cancers (colorectal 43%, gastric/esophageal 25%, pancreas/biliary 32%; Stage I-III 42%, stage IV 58%) receiving chemotherapy (67% poly-chemotherapy) were included. 5-FU chemotherapy was administered alone or in combination in 126 (63%) patients. Sixty five (33%) patients had ≥1 HOS (1 HOS: 55, 2 HOS: 9, 3 HOS: 1). In univariate analysis, hospitalized patients were more likely to be female (p = 0.02), have stage IV disease (p = 0.03), have a diagnosis of non-colorectal GI cancer (p = 0.04), have poly-pharmacy (≥ 5 medications, p < 0.01), decreased hearing (p = 0.05), cardiac comorbidity (p < 0.01), and low serum albumin (p = 0.05). On multivariate analyses, patients who were female (OR = 2.06, 95% CI: 1.05-4.06), with cardiac comorbidity (OR = 3.73, 95% CI: 1.78-7.83), or a diagnosis of stage IV non-colorectal GI cancer (OR = 3.75, 95% CI: 1.50-9.39) were more likely to be hospitalized. Conclusions: HOS during chemotherapy treatment are common among older adults with GI cancers. Female sex, cardiac comorbidity, and a diagnosis of stage IV non-colorectal GI cancer are risk factors for HOS.

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High prevalence of geriatric syndromes in older adults

PLoS ONE ◽

10.1371/journal.pone.0233857 ◽

2020 ◽

Vol 15 (6) ◽

pp. e0233857 ◽

Cited By ~ 6

Author(s):

Angela M. Sanford ◽

John E. Morley ◽

Marla Berg-Weger ◽

Janice Lundy ◽

Milta O. Little ◽

...

Keyword(s):

Older Adults ◽

Geriatric Syndromes ◽

High Prevalence

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Sarcopenia and its Association with Geriatric Syndromes and Quality of Life in Older Indian Outpatients – A Cross-sectional Pilot Observational Study

10.35262/jiag.v15i2.66-74 ◽

2019 ◽

Vol 15 (2) ◽

pp. 66-74

Author(s):

Sunny Singhal ◽

Gevesh Chand Dewangan ◽

Rishav Bansal ◽

Ashish Datt Upadhyay ◽

Sada Nand Dwivedi ◽

...

Keyword(s):

Quality Of Life ◽

Older Adults ◽

Dual Energy ◽

Stepwise Logistic Regression ◽

Care Hospital ◽

Geriatric Syndromes ◽

Dxa Scan ◽

X Ray ◽

Increased Risk

Background: Despite the huge clinical impact of sarcopenia, there is very little to no data from Indian subcontinent regarding sarcopenia in older adults. We conducted this study to assess the frequency of sarcopenia in Indian older outpatients and its characteristics and associations with various geriatric syndromes and quality of life in Indian older adults. Methods: 100 participants above the age of 65 years were recruited from the outpatient department of Geriatric Medicine of a tertiary care hospital in India. Muscle mass, muscle strength and physical performance was measured by DXA scan (Dual Energy X-ray Absorptiometry), hand-held dynamometer and 4 m gait speed respectively. Sarcopenia was identified using an Asian working group for sarcopenia (AWGS) criteria. Many geriatric syndromes such as osteoporosis, dementia, depression and malnutrition were assessed using DXA scan (Dual Energy X-ray Absorptiometry), HMSE (Hindi Mental State Questionnaire), GDS-5 (Geriatric Depression scale – 5 item questionnaire) and MNA (Mini Nutritional Assessment) respectively. Quality of life was assessed using the OPQOL-brief questionnaire. Results: The preval nce of sarcopenia in our study population was 53% (49.3% in males, 61.3% in females). Hypothyroidism, neurological disease and osteoporosis were the only comorbidities found to be positively associated with sarcopenia. Among geriatric syndromes, nutrition and cognition were negatively associated with sarcopenia. Sarcopeniawas also negatively related to the quality of life. Multivariate stepwise logistic regression analysis showed that osteoporosis (OR: 5.43; 95% CI: 1.57-18.81; p-value: <0.01) was significantly associated with sarcopenia. Conclusion: Sarcopenia was common among Indian older outpatients with increased risk of geriatric syndromes and poor quality of life, therefore, a regular sarcopenia assessment may be considered in elderly patients.

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Online Multi-Domain Geriatric Health Screening in Urban Community Dwelling Older Malaysians: A Pilot Study

Frontiers in Public Health ◽

10.3389/fpubh.2020.612154 ◽

2021 ◽

Vol 8 ◽

Author(s):

Deepa Alex ◽

Adhhani Binti Fauzi ◽

Devi Mohan

Keyword(s):

Older Adults ◽

Health Care ◽

Urinary Incontinence ◽

Cognitive Impairment ◽

Pilot Study ◽

Geriatric Assessment ◽

Urban Community ◽

Community Dwelling ◽

Geriatric Syndromes ◽

Online Surveys

Introduction: With a rapidly aging population, the Malaysian health care system needs to develop solutions to address the lack of resources that are required for the assessment of the older person. The complex nature of geriatric syndromes coupled with the occurrence of multiple comorbid illnesses with aging, make geriatric assessment a resource intensive process. Digital health solutions could play an important role in supporting existing health care systems, especially in low and middle income countries, with limited speciality services in geriatrics.Objective: This is a pilot study aimed at screening for geriatric syndromes through self-administered online surveys in urban community dwelling older Malaysians and assessing the pattern of geriatric syndromes in relation to the frailty status of the study participants.Methods: This is a cross-sectional pilot study conducted between July-September 2020. Community dwelling adults aged 60 years and over were invited to take part in an online survey. Information on sociodemographic variables, comorbidities, and the self-reported results of geriatric syndromes (frailty, sarcopenia, anorexia of aging, urinary incontinence, falls, and cognitive impairment), were collected through the survey.Results: Data was collected for 162 participants over a period of 2 months. The mean (SD) age of the respondents was 66.42 (5.25) years with 64.9% females. Majority of the respondents were of Chinese ethnic origin (67.9%) and had tertiary level of education (75.9%). The average time taken by participants to complete the survey was 16.86 min. Urinary incontinence was the highest reported geriatric syndrome (55.1%) followed by falls (37.6%), anorexia of aging (32.8%), cognitive impairment (27.8%), and sarcopenia (8.3%). Frailty was detected in 4.5% of the study population. Loss of weight in the previous year was the highest reported component of the frailty assessment tool. The presence of sarcopenia, anorexia of aging, poor/fair self-rated health, urinary incontinence, and multimorbidity were significantly higher in older adults who were frail or prefrail.Conclusion: Screening for geriatric syndromes through online surveys is a feasible approach to identify older adults in the community who are likely to benefit from geriatric assessment. However, the demographic profile of the older population that are accessible through such digital platforms is limited.

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The main geriatric syndromes in older adults with comorbidity and urinary incontinence in Moscow population

European Urology Open Science ◽

10.1016/s2666-1683(20)33296-1 ◽

2020 ◽

Vol 19 ◽

pp. e1064-e1065

Author(s):

L. Merkusheva ◽

N. Runikhina ◽

E. Borisenko ◽

O. Tkacheva ◽

N. Sharashkina ◽

...

Keyword(s):

Older Adults ◽

Urinary Incontinence ◽

Geriatric Syndromes ◽

Moscow Population

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Animal and Plant Protein Usual Intakes Are Not Associated with Mortality in US Adults (P18-037-19)

Current Developments in Nutrition ◽

10.1093/cdn/nzz039.p18-037-19 ◽

2019 ◽

Vol 3 (Supplement_1) ◽

Cited By ~ 1

Author(s):

Yanni Papanikolaou ◽

Victor Fulgoni

Keyword(s):

Older Adults ◽

Chronic Diseases ◽

Protein Intake ◽

Animal Protein ◽

Plant Protein ◽

Food Sources ◽

Mortality Data ◽

Current Analysis ◽

Increased Risk ◽

Cvd Mortality

Abstract Objectives Previous findings have linked higher animal protein intake with an increase in overall mortality and increased risk of chronic diseases, including cancer and cardiovascular disease (CVD), in older adults, while some data suggest that plant protein food sources may confer health benefits. The objective of the current analysis was to examine associations between all animal protein and plant protein sources with mortality from all-causes, cancer, and CVD, using data from NHANES III. Methods Data in all adults (19–99 years-old (yrs-old); N = 17,199) and older adults (66–99 yrs-old) was linked with mortality data (Mortality N for 19–99 yrs-old = 4280; Mortality N for 66–99 yrs-old = 505), through 2006. Individual usual intakes for protein intake were estimated using the National Cancer Institute method. Results Hazard ratios (HR) models were fit for mortality types (all cause, cancer, CVD) with measures of protein intake. No associations were seen between animal protein intake and all-cause [HR = 1.01; confidence intervals (CI): 0.99–1.02; P = 0.25], cancer [HR = 1.00; CI: 0.98–1.03; P = 0.78], and CVD [HR = 1.01; CI: 0.99–1.02; P = 0.15] mortality. No associations were seen between plant protein intake and all-cause [HR = 0.99; CI: 0.97–1.01; P = 0.17], cancer [HR = 1.01 CI: 0.97–1.05; P = 0.43], and CVD [HR = 1.00; CI: 0.97–1.02; P = 0.69] mortality. Similarly, no associations were seen between animal protein intake and all-cause mortality [HR = 1.00; CI: 0.98–1.01; P = 0.38], and CVD mortality [HR = 1.00; CI: 0.99–1.02; P = 0.51] in older adults, however, a 3% reduction in cancer mortality was linked to animal protein intake [HR = 0.97; CI: 0.94–1.01; P = 0.025]. No associations were seen between plant protein intake and all-cause [HR = 1.00; CI: 0.98–1.03; P = 0.70], cancer [HR = 1.03; CI: 0.97–1.10; P = 0.22] and CVD mortality [HR = 1.01; CI: 0.97–1.04; P = 0.74] in older adults. Conclusions The current results contradict previous findings that have linked animal protein intake to various chronic diseases. Similarly, the current analysis did not link beneficial mortality outcomes with plant protein consumption. A small, but significant beneficial association was seen with animal protein intake in older US adults. Funding Sources Supported by The Beef Checkoff, through the National Cattlemen's Beef Association.

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