title: Six-year follow-up and predictors of urgency-associated urinary incontinence and bowel symptoms among the oldest old: a population-based study.
abstract: Urinary urgency with incontinence, and fecal incontinence and constipation were followed up over a 6-year period in 398 subjects aged 70 years and over at baseline. Age- and gender-adjusted and multivariate Cox proportional hazard models were used to examine the associations of urinary urgency and fecal incontinence and constipation with mortality, and logistic regression models to determine predictors of incident symptoms among the survivors. The proportion of incident cases of urinary urgency with incontinence, fecal incontinence and constipation in the 252 survivors were 17% (n=46), 9% (n=34) and 13% (n=36), respectively. Frequently reported urinary urgency (hazard ratio, HR=2.23; 95% confidence interval, CI=1.37-3.61) and frequently reported fecal incontinence (HR=4.99; CI=2.11-11.79) were associated with mortality when adjusted for age and gender only. In the multivariate analyses, comorbidity (odds ratio, OR=5.54; CI=2.03-15.14), depressive mood (OR=5.78; CI=1.35-24.79) and instrumental activities of daily living (IADL) disability (OR=4.18, CI=1.52-11.50) predicted incident urgency urinary incontinence. Comorbidity (OR=2.91; CI=1.09-7.77) predicted incident fecal incontinence, while no significant predictors were identified for the incident symptom of constipation. Comorbidities and disabilities explain the association of severe urinary and fecal incontinence with mortality.
authors.affiliation: Geriatric Unit, South-Ostrobothnia Hospital District, Seinäjoki Central Hospital, Hanneksenrinne 7, FIN-60220 Seinäjoki, Finland. Electronic address: maria.nuotio@netikka.fi.
authors.forename: Maria
authors.initials: M
authors.lastname: Nuotio
authors.affiliation: Science Center, Pirkanmaa Hospital District and Tampere School of Public Health, University of Tampere, FIN-33014 Tampere, Finland.
authors.forename: Tiina
authors.initials: T
authors.lastname: Luukkaala
authors.affiliation: Department of Urology, Tampere University Hospital and University of Tampere, Teiskontie 35 (PO Box 2000), FIN-33521 Tampere, Finland.
authors.forename: Teuvo L J
authors.initials: TLJ
authors.lastname: Tammela
authors.affiliation: Tampere School of Public Health and Institute for Social Research, University of Tampere, FIN-33014 Tampere, Finland.
authors.forename: Marja
authors.initials: M
authors.lastname: Jylhä
mesh_terms: D000203:Activities of Daily Living; D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging; D003248:Constipation / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D003863:Depression / Q000150:complications / Q000453:epidemiology; D005242:Fecal Incontinence / Q000150:complications* / Q000453:epidemiology / Q000523:psychology; D005260:Female; D005387:Finland / Q000453:epidemiology; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D015995:Prevalence; D016016:Proportional Hazards Models; D012737:Sex Factors; D016019:Survival Analysis; D053202:Urinary Incontinence, Urge / Q000150:complications* / Q000453:epidemiology / Q000523:psychology