title: Frailty, cognitive impairment, and functional disability in older women with female pelvic floor dysfunction.
abstract: OBJECTIVE
  There is a growing body of evidence demonstrating frailty as an important predictor of surgical outcomes in older adults undergoing major surgeries. The age-related onset of many symptoms of female pelvic floor dysfunction (PFD) in women suggests that many women seeking treatment for PFD may also have a high prevalence of frailty, which could potentially impact the risks and benefits of surgical treatment options. Our primary objective was to determine the prevalence of frailty, cognitive impairment, and functional disability in older women seeking treatment for PFD.
  
  
  METHODS
  We conducted a cross-sectional study with prospective recruitment between September 2011 and September 2012. Women, age 65 years and older, were recruited at the conclusion of their new patient consultation for PFD at a tertiary center. A comprehensive geriatric screening including frailty measurements (Fried Frailty Index), cognitive screening (Saint Louis University Mental Status score), and functional status evaluation for activities of daily living (Katz ADL score) was conducted.
  
  
  RESULTS
  Sixteen percent (n/N = 25/150) of women were categorized as frail according to the Fried Frailty Index score. After adjusting for education level, 21.3 % of women (n/N = 32/150) screened positive for dementia and 46 (30.7 %) reported functional difficulty or dependence in performing at least one Katz ADL. Sixty-nine women (46.0 %) chose surgical options for treatment of their PFD at the conclusion of their new patient visit with their physician.
  
  
  CONCLUSIONS
  Frailty, cognitive impairment, and functional disability are common in older women seeking treatment for PFD.
authors.affiliation: Department of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA, Elisabeth.A.Erekson@hitchcock.org.
authors.forename: Elisabeth A
authors.initials: EA
authors.lastname: Erekson
authors.forename: Terri R
authors.initials: TR
authors.lastname: Fried
authors.forename: Deanna K
authors.initials: DK
authors.lastname: Martin
authors.forename: Thomas J
authors.initials: TJ
authors.lastname: Rutherford
authors.forename: Kris
authors.initials: K
authors.lastname: Strohbehn
authors.forename: Julie P W
authors.initials: JP
authors.lastname: Bynum
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D003072:Cognition Disorders / Q000453:epidemiology*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D005260:Female; D016330:Frail Elderly / Q000706:statistics & numerical data*; D015577:Geriatric Assessment; D006801:Humans; D059952:Pelvic Floor Disorders / Q000453:epidemiology* / Q000628:therapy; D056887:Pelvic Organ Prolapse / Q000453:epidemiology* / Q000628:therapy