title: Prevalence of cognitive impairment in older women with pelvic floor disorders.
abstract: OBJECTIVE
  This study aimed to determine the prevalence of mild cognitive impairment (MCI) and early dementia among women >55 years seeking care for pelvic floor disorders (PFDs) and to describe the impact of cognitive impairment on condition-specific quality of life (QoL). We hypothesized that the prevalence of MCI would be at least 15% among this population.
  
  
  METHODS
  This was a cross-sectional study of English-speaking women >55 years presenting for evaluation of PFDs. We assessed baseline demographics and administered the Short Test of Mental Status (STMS) to screen for cognitive impairment. We predicted a sample of 196 would be needed for a precision of ±5% of the estimated sample prevalence in participants with PFDs. Chi-square tests were used to compare categorical variables and Student's t tests and analysis of variance (ANOVA) for continuous variables. Multivariate regression analysis was used to assess for any independent association with cognitive impairment and condition-specific QoL.
  
  
  RESULTS
  Between July 2013 and July 2014, 211 participants were enrolled. The prevalence of MCI and early dementia were 15% [95% confidence interval (CI) 10.9-20.6; n = 32)] and 17% (95% CI 11.9-22.1; n = 36], respectively. Patients with MCI and early dementia had higher Patient Heath Questionnaire scores indicating greater depressive symptoms (p = 0.006) and higher overall Pelvic Floor Impact Questionnaire scores indicating worse condition-specific QoL (p = 0.008).
  
  
  CONCLUSIONS
  MCI and early dementia were prevalent in our population seeking care for PFDs. Women with cognitive impairment experienced worse condition-specific QoL.
authors.affiliation: Division of Urogynecology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA. cynellekunkle@gmail.com.|, 1447 York Road, Suite 100, Lutherville, MD, 21093, USA. cynellekunkle@gmail.com.
authors.forename: Cynelle Murray
authors.initials: CM
authors.lastname: Kunkle
authors.affiliation: Division of Urogynecology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Melinda G
authors.initials: MG
authors.lastname: Abernethy
authors.affiliation: Division of Urogynecology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Lily R
authors.initials: LR
authors.lastname: Van Tongeren
authors.affiliation: Division of Urogynecology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Tola B
authors.initials: TB
authors.lastname: Fashokun
authors.affiliation: Department of Urology, Baltimore, MD, USA.
authors.forename: Edward J
authors.initials: EJ
authors.lastname: Wright
authors.affiliation: Division of Urogynecology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA.
authors.forename: Chi Chiung Grace
authors.initials: CCG
authors.lastname: Chen
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D015142:Baltimore / Q000453:epidemiology; D060825:Cognitive Dysfunction / Q000150:complications / Q000453:epidemiology*; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D059952:Pelvic Floor Disorders / Q000150:complications* / Q000523:psychology; D015995:Prevalence; D011788:Quality of Life
keywords: Cognitive impairment; Urinary incontinence; Uterovaginal prolapse