Karin Stenzelius1, Ulla Molander2, Jenny Odeberg3, Margareta Hammarström4, Karin Franzen5, Patrik Midlöv6, Eva Samuelsson7, Gunnel Andersson8. 1. Faculty of Health and Society, Malmö University and Skåne University Hospital, 205 02 Malmö, Sweden. 2. Sahlgrenska University Hospital, Gothenburg 400 43, Sweden. 3. SBU-The Swedish Council on Health Technology Assessment, Stockholm 103 59, Sweden. 4. Department of Gynecology and Obstetrics and Childrens and Youth Hospital of Queen Silvia, Sahlgrenska University Hospital, 416 85 Gothenburg, Sweden. 5. Department of Gynecology and Obstetrics, Örebro University Hospital, Örebro 701 85, Sweden. 6. Clinical Research Centre (CRC), Skåne University Hospital, 205 02 Malmö, Sweden. 7. Family Medicine, Department of Public Health and Clinical medicine, Umeå University, Umeå 901 85, Sweden. 8. School of Health and Medical Sciences, Örebro University, Örebro 701 85, Sweden.
Abstract
BACKGROUND: urinary incontinence (UI) is a common symptom among older people, with a higher prevalence among frail older persons living in nursing homes. Despite consequences such as reduced health and quality of life, many older people do not seek help for their symptoms, resulting in missed opportunity for treatment. OBJECTIVE: the aim of this study was to investigate the evidence and the effect of conservative treatment of UI and the quality of life among older and frail older persons. METHODS: a systematic review of randomised controlled studies and prospective, non-randomised studies was conducted, evaluating interventions of conservative treatment of UI in an older population (65 years or older). A total of 23 studies fulfilled the inclusion criteria and 9 were of high or moderate quality. Fourteen studies were of low quality and were therefore excluded from the analysis. RESULTS: documented and effective conservative treatments are available even for older persons with UI. Pelvic muscle exercise, physical training in combination with ADL, prompted voiding and attention training, and help to toilet are important treatments. In some studies, however, the evidence of effectiveness is limited. CONCLUSIONS: this systematic review concludes that there are conservative treatments for UI for older and frail older persons that reduce leakage and increase quality of life. There is however a need for further high-quality studies.
BACKGROUND:urinary incontinence (UI) is a common symptom among older people, with a higher prevalence among frail older persons living in nursing homes. Despite consequences such as reduced health and quality of life, many older people do not seek help for their symptoms, resulting in missed opportunity for treatment. OBJECTIVE: the aim of this study was to investigate the evidence and the effect of conservative treatment of UI and the quality of life among older and frail older persons. METHODS: a systematic review of randomised controlled studies and prospective, non-randomised studies was conducted, evaluating interventions of conservative treatment of UI in an older population (65 years or older). A total of 23 studies fulfilled the inclusion criteria and 9 were of high or moderate quality. Fourteen studies were of low quality and were therefore excluded from the analysis. RESULTS: documented and effective conservative treatments are available even for older persons with UI. Pelvic muscle exercise, physical training in combination with ADL, prompted voiding and attention training, and help to toilet are important treatments. In some studies, however, the evidence of effectiveness is limited. CONCLUSIONS: this systematic review concludes that there are conservative treatments for UI for older and frail older persons that reduce leakage and increase quality of life. There is however a need for further high-quality studies.
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