[Five-year follow-up of urinary incontinence in older people in a Spanish rural population]. / Seguimiento durante 5 años de la incontinencia urinaria en los ancianos de una población rural española.

OBJECTIVE: To determine prevalence, incidence and remission rates and change patterns of urinary incontinence (UI) over a 5-year time span. DESIGN: Longitudinal study. LOCATION: Basic Health Zone of Cabra (Cordoba). PATIENTS: A random age-stratified sample of 827 subjects selected from a total of 5139 persons > or = 65 years of age and followed up between 1996 and 2001. INTERVENTIONS: Home interview. MEASUREMENTS: Questions about detection and level of severity of UI, sociodemographic data, and level of functioning. Two logistic regression models were created to identify risk factors for the probability to be alive and to develop UI, respectively. RESULTS: UI prevalence reached 36% at baseline and 46% five years later. Mortality rates were similar in continent and incontinent subjects. 54.5% of continent subjects in 1996 remained so in 2001. Five-year incidence and remission rates were 29% and 15%, respectively. In both sexes, slight and moderate incontinence mainly progressed to moderate and severe degrees, whereas severe UI remained unchanged in 40.1%. The main risk factors for increased survival and for UI incidence were self-rated health and level of functioning. CONCLUSIONS: Prevalence of UI is high, incidence is moderate and remission is low. Urinary incontinence is a dynamic problem and does not affect mortality. Impaired mobility has a strong influence on UI incidence.

[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.

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.