title: Functional status in older women diagnosed with pelvic organ prolapse.
abstract: BACKGROUND
  Functional status plays an important role in the comprehensive characterization of older adults. Functional limitations are associated with an increased risk of adverse treatment outcomes, but there are limited data on the prevalence of functional limitations in older women with pelvic floor disorders.
  
  
  OBJECTIVE
  The aim of the study was to describe the prevalence of functional limitations based on health status in older women with pelvic organ prolapse (POP).
  
  
  METHODS
  This pooled, cross-sectional study utilized data from the linked Health and Retirement Study and Medicare files from 1992 through 2008. The analysis included 890 women age ≥65 years with POP. We assessed self-reported functional status, categorized in strength, upper and lower body mobility, activities of daily living (ADL), and instrumental ADL (IADL) domains. Functional limitations were evaluated and stratified by respondents self-reported general health status. Descriptive statistics were used to compare categorical and continuous variables, and logistic regression was used to measure differences in the odds of functional limitation by increasing age.
  
  
  RESULTS
  The prevalence of functional limitations was 76.2% in strength, 44.9% in upper and 65.8% in lower body mobility, 4.5% in ADL, and 13.6% in IADL. Limitations were more prevalent in women with poor or fair health status than in women with good health status, including 91.5% vs 69.9% in strength, 72.9% vs 33.5% in upper and 88.0% vs 56.8% in lower body mobility, 11.6% vs 0.9% in ADL, and 30.6% vs 6.7% in IADL; all P < .01. The odds of all functional limitations also increased significantly with advancing age.
  
  
  CONCLUSIONS
  Functional limitations, especially in strength and body mobility domains, are highly prevalent in older women with POP, particularly in those with poor or fair self-reported health status. Future research is necessary to evaluate if functional status affects clinical outcomes in pelvic reconstructive and gynecologic surgery and whether it should be routinely assessed in clinical decision-making when treating older women with POP.
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD. Electronic address: tsanses@fpi.umaryland.edu.
authors.forename: Tatiana V D
authors.initials: TV
authors.lastname: Sanses
authors.affiliation: Case Western Reserve University, Cleveland, OH.
authors.forename: Nicholas K
authors.initials: NK
authors.lastname: Schiltz
authors.affiliation: Cleveland Clinic, Cleveland, OH.
authors.forename: Bruna M
authors.initials: BM
authors.lastname: Couri
authors.affiliation: Case Western Reserve University, Cleveland, OH; University Hospitals Case Medical Center, Cleveland, OH.
authors.forename: Sangeeta T
authors.initials: ST
authors.lastname: Mahajan
authors.affiliation: University of Alabama at Birmingham School of Medicine, Birmingham, AL.
authors.forename: Holly E
authors.initials: HE
authors.lastname: Richter
authors.affiliation: University of Nebraska-Lincoln, Lincoln, NE.
authors.forename: David F
authors.initials: DF
authors.lastname: Warner
authors.affiliation: University of Maryland School of Medicine, Baltimore, MD.
authors.forename: Jack
authors.initials: J
authors.lastname: Guralnik
authors.affiliation: Case Western Reserve University, Cleveland, OH.
authors.forename: Siran M
authors.initials: SM
authors.lastname: Koroukian
mesh_terms: D000203:Activities of Daily Living; D000368:Aged; D000369:Aged, 80 and over; D000375:Aging / Q000502:physiology; D003430:Cross-Sectional Studies; D005260:Female; D006304:Health Status; D006306:Health Surveys; D006801:Humans; D006278:Medicare; D008875:Middle Aged; D051346:Mobility Limitation; D053580:Muscle Strength / Q000502:physiology; D056887:Pelvic Organ Prolapse / Q000453:epidemiology* / Q000503:physiopathology; D014481:United States / Q000453:epidemiology; D034941:Upper Extremity / Q000503:physiopathology
keywords: activities of daily living; functional status; limitations; mobility; pelvic organ prolapse; strength