ABSTRACTBased on the national Canadian Study of Health and Aging, the objective of this study was to determine the importance of socio-demographic and medical factors, cognitive and functional status as predictors of the development of urinary incontinence, and to estimate five-year incidence by sex and age group. Participants from the Canadian Study of Health and Aging who underwent a clinical examination in 1992 and were continent for urine at the time were followed up and their continence status was again determined in 1997. Multivariate logistic regression models with daily incontinence and daily or less than daily incontinence as the outcomes were developed separately for male (n = 306) and female (n = 520) survivors. Predictor variables were introduced in the following chunks: socio-demographic factors; cognitive status; functional status, diabetes and stroke. Five-year cumulative incidence of daily and less than daily incontinence by sex and age group was also estimated. Results indicated that the incidence of urinary incontinence was higher in women than in men, and increased by age in both men and women. Especially among men, those in institutions were much more likely to develop urinary incontinence than those in the community. Incontinence increased dramatically with severity of dementia, less so with physical immobility. Diabetes mellitus was related to the development incontinence in men but not in women, prior stroke was related to development of incontinence in both sexes. It is concluded that urinary incontinence is common in older persons, and enquiries about its presence should be part of routine medical and nursing assessment of older persons. Those who develop incontinence commonly have dementia and are physically impaired. The extent of assessment and management should be carefully tailored to each individual patient.
摘要本研究以加拿大全国健康与老龄化研究为基础,旨在确定社会人口和医疗因素、认知和功能状况对尿失禁发生的重要预测作用,并按性别和年龄组估计五年的发病率。对加拿大健康与老龄化研究(Canadian Study of Health and Aging)中于 1992 年接受临床检查并在当时排尿的参与者进行了跟踪调查,并于 1997 年再次确定了他们的尿失禁状况。分别为男性(306 人)和女性(520 人)幸存者建立了以每日尿失禁和每日或少于每日尿失禁为结果的多变量逻辑回归模型。预测变量分为以下几组:社会人口因素、认知状况、功能状况、糖尿病和中风。此外,还估算了按性别和年龄组分列的每日尿失禁和小于每日尿失禁的五年累计发生率。结果表明,女性尿失禁的发生率高于男性,而且随着年龄的增长,男女尿失禁的发生率均有所上升。尤其是在男性中,住在养老院的人比住在社区的人更容易出现尿失禁。尿失禁随痴呆症的严重程度而急剧增加,但随身体活动不便而增加。糖尿病与男性尿失禁的发生有关,但与女性无关。结论是,尿失禁在老年人中很常见,对老年人进行常规医疗和护理评估时应询问是否存在尿失禁。出现尿失禁的老年人通常患有痴呆症且身体机能受损。评估和处理的程度应根据每位患者的具体情况认真制定。