title: The association of depressive symptoms and urinary incontinence among older adults.
abstract: OBJECTIVE
  To examine the relationship of urinary incontinence (UI) and depressive symptoms (DS) in older adults.
  
  
  METHODS
  A randomized, controlled trial to determine the effects of clinical practice guideline implementation on provider attitudes and behavior, and patients' UI, health status, quality of life, and satisfaction with care. Baseline and endpoint data were collected from patients via computer-assisted telephone interviewing.
  
  
  METHODS
  Forty-one nonacademic primary care practices (PCP) in North Carolina.
  
  
  METHODS
  A total of 668 community-dwelling adults (age > 60) who had visited the one of the selected PCPs.
  
  
  METHODS
  PCPs in the intervention group were given instruction in the detection and management of UI, educational materials for providers and patients, office system supports, and academic detailing.
  
  
  METHODS
  The dependent measure was assessed using an eight-item screener for DS. UI (status, frequency, amount), health (physical, mental), and demographic (age, gender, marital status) and self-report information about bladder control served as predictors.
  
  
  RESULTS
  Wilcoxon rank sum tests showed that UI status was associated with moderate to severe DS (43% vs 30%, P = .05). Multivariate analyses showed that UI status, physical and mental health, and gender were significant predictors of DS. Among UI adults (n = 230), physical and mental health, life satisfaction, and the perception that UI interfered with daily life were significant predictors of DS.
  
  
  CONCLUSIONS
  This study provides clear evidence that UI is related to DS in older adults.
authors.affiliation: The Department of Public Health Sciences, The Wake Forest University School of Medicine, Winston-Salem, North Carolina 27157-1063, USA.
authors.forename: E
authors.initials: E
authors.lastname: Dugan
authors.forename: S J
authors.initials: SJ
authors.lastname: Cohen
authors.forename: D R
authors.initials: DR
authors.lastname: Bland
authors.forename: J S
authors.initials: JS
authors.lastname: Preisser
authors.forename: C C
authors.initials: CC
authors.lastname: Davis
authors.forename: P K
authors.initials: PK
authors.lastname: Suggs
authors.forename: P
authors.initials: P
authors.lastname: McGann
mesh_terms: D017677:Age Distribution; D000368:Aged; D001294:Attitude to Health; D003863:Depression / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D015577:Geriatric Assessment; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009657:North Carolina; D017060:Patient Satisfaction; D017410:Practice Guidelines as Topic; D011320:Primary Health Care; D017678:Sex Distribution; D014549:Urinary Incontinence / Q000150:complications* / Q000523:psychology