Factors influencing urinary incontinence in elderly and its impact on quality of life

AIMS & OBJECTIVES: 1. To evaluate the factors influencing urinary incontinence. 2. To evaluate the impact of urinary incontinence on the quality of life. METHODOLOGY: Study Centre: Geriatric Medicine OPD, Rajiv Gandhi Government General Hospital, Chennai. Study Duration: 6 months. Study Design: Cross sectional and observational study. Sample size: 500 patients. Inclusion Criteria: Patients above 65 years of age and willing to participate in the study. Exclusion Criteria: Patients not willing for study, Patients with severe cognitive impairment. Procedure: Patients were selected as per above said inclusion & exclusion criteria. Detailed history with comorbiare elicited by questionnaire. Clinical examination, Mental status examination, routine urine analysis, urine culture, blood sugar, ultrasound abdomen and pelvis were performed. Revised urinary incontinence scale (selected from Urogenital Distress Inventory, Incontinence severity index) to assess the severity of symptoms, International Prostate System Score, King’s Health questionnaire, Geriatric depression scale to assess the quality of life were used. RESULTS: Prevalence of urinary incontinence was found to be 16.4%.The prevalence rate was 11.2% among men and 21.6% among women. It was found that urinary incontinence increased with age in both sexes. 53 patients above 75years of age had urinary incontinence and this association was found to be statistically significant with p value 0.0009.Among 52 patients who had education upto primary school, 40 patients seeked medical treatment only after 2 years of symptoms. Urinary incontinence was found to be significantly associated with factors like female sex, diabetes mellitus, chronic respiratory disease, stroke, heart disease, arthritis, Parkinson’s disease, gastrointestinal disorders, cystitis, uterine prolapse, prostate enlargement with p value less than 0.005. Percentage of urge, stress, mixed incontinence among male and female were 57.1%, 14.2%, 28.5 and 29.6%, 48.1%, 23% respectively. Among males and females. severity of the condition was mild in 39.2%and 44.4%, moderate in 25% and 24%,severe in 35.7% and 31.4% respectively. Male patients had poor quality of life with urinary incontinence with p <0.00001. In females, urinary incontinence was significantly associated with poor general health perception, daily activity limitation, social limitation, physical limitation, personal limitation and emotional problems with p value