A scoping review of risk factors for urinary incontinence in older men

Abstract

Background Most epidemiological studies have not systematically identified or categorized risk factors for urinary incontinence (UI) in older men, despite a higher prevalence than in younger men. Considering the burden of UI, an understanding of risk factors can inform cost-effective prevention/treatment programs. This scoping review aimed to identify and categorise risk factors for UI in older men, identify gaps in the evidence, and opportunities for future research. Methods The Joanna Briggs Institute (JBI) method for scoping reviews guided the conduct and reporting of this review alongside the Preferred Reporting Items for Systematic Reviews and Meta-analyses extension for scoping reviews checklist. JBI’s Population, Concept, and Context approach framed the inclusion criteria (all evidence sources on UI risk factors that included older men [65 +]). We employed JBI’s three-step search strategy, which included a limited initial search in Ovid MEDLINE, a detailed comprehensive database search, and a search of reference lists of included studies, Google Scholar and grey literature. There were no restrictions on language, study type, or publication date. Two independent reviewers screened, selected, and extracted eligible studies. Data were analyzed using descriptive statistics and qualitative content analysis. Results Forty-seven articles that met the inclusion criteria identified 98 risk factors across six categories. Behavioural risk factors, reported by only two studies, were the least investigated of all the categories, whereas medical factors/diseases were the most investigated. No genetic factors were documented. The top five risk factors were increasing age/advanced age (n = 12), Benign Prostatic Hyperplasia (n = 11), Diabetes Mellitus (n = 11), Detrusor overactivity (n = 10), limitation in physical function/ADL disability (n = 10), increased Body Mass Index (BMI)/overweight/obesity (n = 8), Dementia (n = 8), and Parkinson’s disease (n = 7). Conclusion There is a dearth of evidence to describe the role behavioural risk factors have in UI in older men. These factors may play a role in health promotion and disease prevention in this area. Registration A protocol detailing the methods was developed and published, and is registered in the Open Science Framework [Feb 07 2023; https://osf.io/xsrge/].

Exploring Early, Middle, and Late Loss in Basic Activities of Daily Living among Nursing Home Residents: A Multicenter Observational Study

“…The association between limitations in BADLs and incontinence may operate bidirectionally, acting as a mutual risk factor. Incontinence can contribute to the onset of BADL impairment, and conversely, BADL impairments may serve as a risk factor for the development of incontinence [6,[37][38][39]. Coll-Planas et al ( 2008) not only proposed incontinence and disability as risk factors for each other but also suggested a shared set of risk factors, such as white matter changes, stroke, and other neurological conditions [39].…”

“…Marital status (married or in a relationship)38 (35.8%) 68 (64.2%) 0.050 1.55 (1.00-2.40) Residents' outdoor accessibility 187 (28.5%) 468 (71.5%) 0.050 5.994 (0.79-45.70) CI: confidence interval; OR: odds ratio; SD: standard deviation.…”

Dialysis for older adults: why should the targets be different?

“…The KDOQI clinical guidelines do recommend that less than the standard thrice weekly 4-h dialysis sessions can be offered to patients with residual renal urea clearance > 3 mL/ min/1.73 m 2 . However, elderly frail patients are less likely to be able to accurately carry out 24-h urine collections due to immobility, incontinence, and dementia [24,25], and even if urine can be collected, residual renal urea clearance simply reflects glomerular clearance. While combining urea and creatinine clearance more closely resembles inulin clearance, the benefits of residual kidney function may not solely be due to glomerular filtration but might also reside with renal tubular secretion of protein-bound uraemic toxins and clearance of middle molecules.…”

A protocol for the co-creation and usability/acceptability testing of an evidence-based, patient-centred intervention for self-management of urinary incontinence in older men

“…No existing self-management interventions for UI focus on the needs of older men and none incorporate the perspectives of older men into their development. Furthermore, the health inequalities and disparities in continence services for men, and a low level of health seeking in men with UI make it crucial to incorporate their perspectives into intervention development to ensure optimal outcomes [8,22].…”

“…This study will build on systematically synthesized evidence on risk factors for UI in older men [22,38], as well as continence experts’ consensus on factors that are potentially modifiable, and older men’s perspectives on what they find practicable and are willing to modify, as well as their preferred mode of intervention delivery to co-create a self-management intervention.…”