Predicting continence decline in institutionalized older people: A longitudinal analysis

Aims To verify the incidence of urinary continence decline and the probability of maintaining urinary continence, as well as identify the prognostic factors of urinary continence decline in institutionalized older people. Methods A 2‐year longitudinal study (with five 6‐month waves) was conducted wi...

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Published in:Neurourology and urodynamics 2019-03, Vol.38 (3), p.958-967
Main Authors: Jerez‐Roig, Javier, Moreira, Francisca Sueli Monte, da Câmara, Saionara Maria Aires, Ferreira, Lidiane Maria de Brito Macedo, Lima, Kenio Costa
Format: Article
Language:English
Subjects:
Accidental Falls
Aged
Aged, 80 and over
Brazil - epidemiology
Cognitive ability
Cognitive Dysfunction - psychology
Cohort Studies
Disability Evaluation
Disabled Persons
Female
Fractures
Hospitalization - statistics & numerical data
Humans
Inappropriate Prescribing
Incidence
Institutionalization
Longitudinal Studies
Male
Middle Aged
Nursing Homes
Older people
Predictive Value of Tests
Prognosis
Prospective Studies
Socioeconomic Factors
Urinary incontinence
Urinary Incontinence - epidemiology
Urinary Incontinence - physiopathology
Urinary Incontinence - psychology
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Summary:Aims To verify the incidence of urinary continence decline and the probability of maintaining urinary continence, as well as identify the prognostic factors of urinary continence decline in institutionalized older people. Methods A 2‐year longitudinal study (with five 6‐month waves) was conducted with subjects ≥60 years old who lived in 10 nursing homes in the city of Natal‐RN (Brazil). Urinary incontinence was assessed by the Minimum Data Set version 3.0. Sociodemographic, institution‐related and health‐related variables were considered to establish the baseline. Time‐dependent variables included cognitive decline, functional decline, and incidences of falls, hospitalizations, and fractures during the period. The actuarial method, the log‐rank test, and Cox’s regression were applied as statistical methods. Results Among the cohort of 196 older adults, 105 (53.6%) individuals maintained the continence status during the period, 21 (10.7%) improved it at one or more assessments, and 76 (38.8%) subjects declined. The cumulative probability of maintaining continence status was 82.6% (confidence interval [CI], 95%: 76.5%‐87.3%), 74.7% (CI, 95%: 67.8%‐80.4%), 66.9% (CI, 95%: 59.4%‐73.2%), and 49.3% (CI, 95%: 40.1%‐57.9%) at 6, 12, 18, and 24 months, respectively. Predicting factors for continence decline were: disability (hazard ratio [HR] = 4.03; P 
ISSN:0733-2467
1520-6777
DOI:10.1002/nau.23941