[Use of devices for urinary incontinence among the elderly of the basic health area of Cabra (Córdoba)]. / Uso de accesorios para incontinencia urinaria en los ancianos de la Zona Básica de Salud de Cabra (Córdoba).

AIMS: To study the proportion and characteristics of elderly people who use aids for urinary incontinence, and the economic cost of pads. DESIGN: Cross-sectional study. INTERVENTIONS: A specific questionnaire on urinary incontinence and Barthel and Lawton indexes; and economic analysis of the number of pads used. LOCATION: Basic Health Zone of Cabra (Córdoba). PATIENTS: 827, among a total of 5139 > or = 65 years-old subjects, by means of a random sampling, classified in age groups. MEASUREMENTS: Two sources of data were used: a home health interview gathering information about the use of aids; the register which controls the prescription of pads in the Basic Health Zone of Cabra. MAIN RESULTS: Urinary incontinence was detected in 36% of elderly people. Sixty-three percent of the incontinent people used some sort of aid, 8.1% used pads and 2.9% used an urethral catheter. The use of aids was related to advanced age, female gender and functional dependence. In 1996, the cost of the pads was 19,416,298 pesetas and 51,659 pesetas per incontinent person. CONCLUSIONS: The overall prevalence of the use of aids was greater than or similar to that of other studies whereas the use of pads was less. During 1996 the average cost of the pads per elderly person amounted to 49% of the theoretical maximum cost permitted by the health authority.

Association of individual activities of daily living with self-rated health in older people.

OBJECTIVE: to evaluate the associations of 18 activities of daily living with self-rated health in older people. DESIGN AND SETTING: cross-sectional study of a representative sample of 781 people aged 65 or over (response rate: 89.9%). METHODS: self-rated health was assessed by the question: "Overall, how would you rate your current health status-very good, good, fair, poor or very poor?" We used the Barthel index and Lawton and Brody's index for basic and instrumental activities of daily living, respectively. We classified subjects into three groups according to their Barthel index score: level 1 (score 100), level 2 (score 91-99) and level 3 (score 0-90). Logistic regression was used to identify associations between each activity and self-rated health. RESULTS: use of stairs [odds ratio (OR) = 4.28, 95% confidence interval (95% CI): 2.82-6.52], ambulation (OR = 3.67, 95% CI: 2.39-5.64) and chair/bed transfer (OR = 3.00, 95% CI: 1.68-5.36) were the basic activities of daily living best associated with self-rated health. Among instrumental activities of daily living, ability to handle finances (OR = 2.20), laundry (OR = 2.15) and transport (OR = 2.12) were associated with self-rated health. On the Barthel index, only transport was associated with self-rated health in subjects at levels 1 (OR = 2.55) and 2 (OR = 2.72). For subjects with poor functional status (level 3), no instrumental activities of daily living were related to self-rated health. CONCLUSION: in terms of self-rated health, the most important activities of daily living were those involving mobility. The effect of each instrumental activity of daily living on self-rated health depends on the level of functional capacity in basic activities of daily living.

Prevalence and psychosocial impact of urinary incontinence in older people of a Spanish rural population.

BACKGROUND: The prevalence and the psychosocial impact of urinary incontinence in older people of a rural population were investigated. METHODS: A cross-sectional study was made by means of a home health interview in a representative sample of people aged 65 years and older in the Basic Health Zone of Cabra (Córdoba). A questionnaire was used with two questions to detect urinary incontinence and further questions regarding its duration, frequency, volume, severity and psychosocial impact. Data were analyzed with basic statistics. A logistic regression model was created to identify which factors affect people's lifestyles. RESULTS: Among the 827 respondents the prevalence of incontinence reached 36% [95% confidence interval (CI): 34%-38%] and was higher (p < .001) in women (42%; 95% CI: 39%-45%) than in men (29%; 95% CI: 25%-38%). The most frequent duration of incontinence was from 1 to 5 years (16.8%). Fifteen percent had daily episodes and 10.6% estimated the volume of urine loss as high. Incontinence was severe in 9% of the affected subjects. Half the incontinent subjects expressed social limitations and negative feelings related to incontinence, and 21% admitted that incontinence negatively affected their lives. In the logistic regression model, both volume of urine loss [odds ratio (OR) = 5.61; 95% CI: 2.76-11.42] and being married (OR = 2.34; 95% CI: 1.03-5.33) were the factors statistically associated with a negative influence of incontinence on lifestyle. CONCLUSIONS: Urinary incontinence is a very frequent symptom in our population. Half the incontinent subjects suffer from some degree of psychosocial limitation. The volume of urine loss and being married are the most important factors with psychosocial impact.

[Expectancy in urinary incontinence treatment from the perspective of an elderly population]. / Expectativas del tratamiento de la incontinencia urinaria vistas desde una población de ancianos.

AIMS: To determine the attitudes of community-dwelling elderly patients about the possibilities for cure of urinary incontinence. DESIGN: Cross-sectional study. INTERVENTIONS: A specific questionnaire on urinary incontinence and the Barthel Index Modified by Shah. LOCATION: Basic Health Zone of Cabra (Córdoba, Spain). PATIENTS: A random age-stratified sample of 793 patients selected from a total of 5139 persons > or = 65 years of age. MEASUREMENTS: Home interview on urinary incontinence (presence, characteristics, patient attitude regarding possibilities for cure). PRINCIPAL RESULTS: Forty-eight percent of elderly persons felt that incontinence could be cured, 21% thought that it could be improved, 9% stated that nothing could be done about it and the remaining 22% had no opinion. A significant association was found between the type of response and age, sex, state of health as perceived by the subject and level of self-care. The presence of incontinence did not influence the nature of the responses given by patients about the possibilities for successful treatment of incontinence. CONCLUSIONS: Our elderly persons were not aware of the possibilities for treatment of incontinence, a fact that may have a negative impact on sufferers seeking help for this remediable problem.