title: Life Space Assessment in Older Women Undergoing Non-Surgical Treatment for Urinary Incontinence.
abstract: OBJECTIVE
  Urinary incontinence (UI) impacts all aspects of life activities. This study aims to characterize change in mobility within the community utilizing the Life Space Assessment (LSA) questionnaire in women undergoing non-surgical UI treatment.
  
  
  METHODS
  Prospective cohort study, performed from July 2007 to March 2009, which followed women seeking non-surgical UI treatment and assessed their mobility and symptoms using LSA, Urogenital Distress Inventory (UDI-6), and Incontinence Impact Questionnaire (IIQ-7) at baseline and 2, 6, and 12 months post-treatment. Estimated Percent Improvement (EPI) and Patient Satisfaction Question (PSQ) were obtained post-treatment.
  
  
  METHODS
  Outpatient tertiary-care clinic.
  
  
  METHODS
  70 ambulatory, community-dwelling women, aged 65 years or older, seeking non-surgical care for UI.
  
  
  METHODS
  Multi-component behavioral and/or pharmacologic therapies.
  
  
  METHODS
  We hypothesized LSA would improve with treatment. Repeated measures analysis with Tukey's HSD and backwards selection linear regression model were performed.
  
  
  RESULTS
  LSA score decreased from baseline to 2 months (mean±SD; 63±29 to 56±28, p<0.001) and was sustained at 6 and 12 months (54±28, 54±28). UDI scores improved from 36±23 to 25±24, p<0.001, at 2 months, and improvement persisted at 6 and 12 months (22±22, 21±24). Improvements in UDI and patient perceived improvement in UI were not associated with LSA change. Age, race, and depression impacted LSA, which decreased 1-point for each additional year of age (p=0.004), 6-points for each point higher on the Geriatric Depression Scale (GDS) (p=0.002), and 6-points for African American race (p=0.048).
  
  
  CONCLUSIONS
  Decreased mobility represented by LSA was related to age, depression, and race, but not UI symptom improvement.
authors.affiliation: Department of Obstetrics and Gynecology, University of South Carolina School of Medicine-Greenville, Greenville, SC.
authors.forename: Thomas L
authors.initials: TL
authors.lastname: Wheeler
authors.affiliation: Department of Obstetrics and Gynecology, University of South Carolina School of Medicine-Greenville, Greenville, SC.
authors.forename: Jana D
authors.initials: JD
authors.lastname: Illston
authors.affiliation: Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Alayne D
authors.initials: AD
authors.lastname: Markland
authors.affiliation: Division of Gerontology, Geriatrics, and Palliative Care, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Patricia S
authors.initials: PS
authors.lastname: Goode
authors.affiliation: Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, AL.
authors.forename: Holly E
authors.initials: HE
authors.lastname: Richter
keywords: community-dwelling women; depression; life-space; mobility; urinary incontinence