Philip J Schluter1,2, Edwin P Arnold3, Hamish A Jamieson4,5. 1. School of Health Sciences, University of Canterbury - Te Whare Wānanga o Waitaha, Christchurch, New Zealand. 2. School of Nursing, Midwifery and Social Work, The University of Queensland, Brisbane, Australia. 3. Department of Surgery, University of Otago, Christchurch, New Zealand. 4. Department of Medicine, University of Otago, Christchurch, New Zealand. 5. Older Person's Health, Canterbury District Health Board, Christchurch, New Zealand.
Abstract
AIMS: To determine if urinary incontinence (UI) was an independent risk factor for falls and hip fractures in community-dwelling older men and women with complex needs, after controlling for confounders. METHODS: Since 2012, all community care recipients in New Zealand have undergone standardized needs assessments using the Home Care International Residential Assessment Instrument (interRAI-HC). The interRAI-HC elicits information over multiple domains, including UI frequency and falls. Those aged 65+ years with assessment between July 1, 2012 and May 31, 2014 without collection devices or indwelling catheters were matched to hospital, mortality, and pharmaceutical databases, and apposite regression models applied. RESULTS: Overall, 25 257 (37.5%) men and 42 032 (62.5%) women were eligible, with average age of 82.7 years (range: 65, 106 years). Incontinence was reported by 34.3% of men and 42.6% of women, falls within 90 days by 42.7% of men and 39.1% of women; and fractures recorded for 2.5% of men and 3.7% of women. In multivariable analysis, UI was significantly associated with falls (P < 0.001), and differentially related by sex (P < 0.001). Compared to continent participants, the odds of increasing falls risk was 1.69 (95% CI: 1.57, 1.82) for men with frequent incontinence and 1.53 (95% CI: 1.43, 1.64) for men with occasional continence; higher than the 1.39 (95% CI: 1.32, 1.46) and 1.33 (95% CI: 1.26, 1.39), respectively, for women. UI was not associated with hip fractures. CONCLUSION: UI is a common independent risk factor for falls but not hip fractures. Patterns are different between men and women with complex needs.
AIMS: To determine if urinary incontinence (UI) was an independent risk factor for falls and hip fractures in community-dwelling older men and women with complex needs, after controlling for confounders. METHODS: Since 2012, all community care recipients in New Zealand have undergone standardized needs assessments using the Home Care International Residential Assessment Instrument (interRAI-HC). The interRAI-HC elicits information over multiple domains, including UI frequency and falls. Those aged 65+ years with assessment between July 1, 2012 and May 31, 2014 without collection devices or indwelling catheters were matched to hospital, mortality, and pharmaceutical databases, and apposite regression models applied. RESULTS: Overall, 25 257 (37.5%) men and 42 032 (62.5%) women were eligible, with average age of 82.7 years (range: 65, 106 years). Incontinence was reported by 34.3% of men and 42.6% of women, falls within 90 days by 42.7% of men and 39.1% of women; and fractures recorded for 2.5% of men and 3.7% of women. In multivariable analysis, UI was significantly associated with falls (P < 0.001), and differentially related by sex (P < 0.001). Compared to continent participants, the odds of increasing falls risk was 1.69 (95% CI: 1.57, 1.82) for men with frequent incontinence and 1.53 (95% CI: 1.43, 1.64) for men with occasional continence; higher than the 1.39 (95% CI: 1.32, 1.46) and 1.33 (95% CI: 1.26, 1.39), respectively, for women. UI was not associated with hip fractures. CONCLUSION: UI is a common independent risk factor for falls but not hip fractures. Patterns are different between men and women with complex needs.
Authors: Rebecca Abey-Nesbit; Philip J Schluter; Tim Wilkinson; John Hugh Thwaites; Sarah D Berry; Hamish A Jamieson Journal: BMC Geriatr Date: 2019-03-25 Impact factor: 3.921
Authors: Sabine Britting; Rada Artzi-Medvedik; Paolo Fabbietti; Lisanne Tap; Francesco Mattace-Raso; Andrea Corsonello; Fabrizia Lattanzio; Johan Ärnlöv; Axel C Carlsson; Regina Roller-Wirnsberger; Gerhard Wirnsberger; Tomasz Kostka; Agnieszka Guligowska; Francesc Formiga; Rafael Moreno-Gonzalez; Pedro Gil; Sara Lainez Martinez; Robert Kob; Itshak Melzer; Ellen Freiberger Journal: BMC Geriatr Date: 2020-10-02 Impact factor: 3.921