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. 2015 Dec;69(12):1517-24.
doi: 10.1111/ijcp.12740. Epub 2015 Sep 9.

Prevalence, management and outcomes of medically complex vulnerable elderly patients with urinary incontinence in the United States

X Luo  1 , C-C Chuang  2 , E Yang  2 , K H Zou  3 , A L Araiza  4 , T Bhagnani  2
Affiliations

Prevalence, management and outcomes of medically complex vulnerable elderly patients with urinary incontinence in the United States

X Luo et al. Int J Clin Pract. 2015 Dec.

Abstract

Objectives: To assess the prevalence, patient-physician communication, treatment and health outcomes associated with urinary incontinence (UI) among the medically complex vulnerable elderly (MCVE) in the United States (US).

Methods: Data from the 2006 to 2012 Medicare Health Outcomes Survey (HOS) were used. MCVE patients were aged 65+ years with a HOS VE score ≥ 3. UI was reported as a small, big or no problem. Descriptive statistics were used to assess patient-physician communication and treatment. Multivariable regression analyses were performed to assess the association of small or big UI problems with various outcomes.

Results: The annual UI prevalence increased among MCVE [from 35.8% (2006) to 38.6% (2012)]. MCVE with big UI problems communicated with their physicians more often than those with small UI problems (77.9% and 49.6%, respectively); however, treatment of UI remained low (48.5% and 29.1%, respectively). Physical component summary (PCS) and mental component summary (MCS) scores were lower among MCVE with small or big UI problems compared with those with no UI problems, respectively. The decrements in PCS and MCS scores associated with big UI problems were greater than the decrements associated with any of the other assessed conditions. MCVE with small or big UI problems, respectively, were more likely to report past falls, depression and activity daily living limitations vs. those without UI. The odds of having experienced these outcomes were greater for those with big UI vs. small UI problems.

Conclusions: Urinary incontinence prevalence in the USA increased among MCVE from 2006 to 2012, although treatment of UI remained low. UI problems, particularly big UI problems, adversely impact health outcomes. Efforts to better identify and manage UI among the MCVE are needed.

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Figures

Figure 1
Figure 1
Estimated annual prevalence of UI problems among MCVE by calendar year (A) and estimated annual prevalence of UI problems among general elderly (B). Percentages were based on rounding to the first decimal place
Figure 2
Figure 2
Percentage of MCVE patients who communicated with physicians about UI problems (A) and percentage of MCVE patients receiving treatment (B). Percentages were based on rounding to the first decimal place
See this image and copyright information in PMC

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