Urinary incontinence, but not fecal incontinence, is a risk factor for admission to aged residential care of older persons in New Zealand

Schlüter, Philip J.; Ward, Charlotte; Arnold, E. P.; Scrase, Richard; Jamieson, Hamish A.

doi:10.1002/nau.23160

Cited by 32 publications

(31 citation statements)

References 20 publications

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“…However, other studies reported an absence of interaction between UI and FI on the prediction of institutionalization [22,23]. Discrepancies may stem from methodological differences as we used multivariate analysis while other studies have applied univariate analysis [23,24]. Moreover, the lack of distinction between UI and FI [20] and absence of consensus on the definition of FI may explain different effects of FI on institutionalization [24].…”

Section: Discussionmentioning

confidence: 91%

“…This observation suggests that as the severity of incontinence increases, so does the risk of NH admission. However, other studies reported an absence of interaction between UI and FI on the prediction of institutionalization [22,23]. Discrepancies may stem from methodological differences as we used multivariate analysis while other studies have applied univariate analysis [23,24].…”

Section: Discussionmentioning

confidence: 91%

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Impact of urine and mixed incontinence on long-term care preference: a vignette-survey study of community-dwelling older adults

et al. 2020

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Background: In view of population aging, a better knowledge of factors influencing the type of long-term care (LTC) among older adults is necessary. Previous studies reported a close relationship between incontinence and institutionalization, but little is known on opinions of older citizens regarding the most appropriate place of care. This study aimed at evaluating the impact of urine and/or fecal incontinence on preferences of communitydwelling older citizens. Methods:We derived data from the Lausanne cohort 65+, a population-based study of individuals aged from 68 to 82 years. A total of 2974 community-dwelling persons were interviewed in 2017 on the most appropriate place of LTC delivery for three vignettes displaying a fixed level of disability with varying degrees of incontinence (none, urinary, urinary and fecal). Multinomial logistic regression analyses explored the effect of respondents' characteristics on their opinion according to Andersen's model. Results: The level of incontinence described in vignettes strongly determined the likelihood of considering institutional care as most appropriate. Respondents' characteristics such as age, gender, educational level, being a caregiver, knowledge of shelter housing or feeling supported by family influenced LTC choices. Self-reported incontinence and other indicators of respondents' need, however, had no significant independent effect.Conclusion: Among older community-dwelling citizens, urinary and fecal incontinence play a decisive role in the perception of a need for institutionalization. Prevention and early initiation of support for sufferers may be a key to prevent this need and ensure familiar surrounding as long as possible.

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Section: Discussionmentioning

confidence: 91%

Section: Discussionmentioning

confidence: 91%

Impact of urine and mixed incontinence on long-term care preference: a vignette-survey study of community-dwelling older adults

et al. 2020

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“…These results have been challenged by a review criticizing methodological quality of studies on a possible association between nursing home admission and toileting difficulties and by questioning the role of incontinence as an independent risk factor for nursing home admission (Holroyd‐Leduc et al, ; Luppa et al, ). A recent study investigated the role of urinary incontinence and faecal incontinence separately and found urinary incontinence, but not faecal incontinence, to be an independent risk factor for nursing home admission (Schluter, Ward, Arnold, Scrase, & Jamieson, ). A Norwegian study on nursing home admission and death using the same study material as used in our study found that lower personal functioning in activities of daily living (ADL) was associated with a higher risk of nursing home admission.…”

Section: Discussionmentioning

confidence: 99%

Toileting difficulties in older people with and without dementia receiving formal in‐home care—A longitudinal study

et al. 2019

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Aim To estimate the prevalence of toileting difficulties over time among older people (≥70 years) with and without dementia receiving formal in‐home care at baseline and to explore whether dementia at baseline was associated with toileting difficulties at the last assessment when adjusting for relevant covariates. We hypothesize that those with dementia have a higher prevalence and that baseline dementia is associated with toileting difficulties at last follow‐up. Design A longitudinal observational study with three assessments over 36 months. Older people (≥70 years) from 19 Norwegian municipalities with in‐home care needs were included. The participants and their next of kin were interviewed. Method In total, 1,001 (68% women) persons with a mean ( SD ) age 83.4 (5.7) years participated at baseline. Toileting difficulties were assessed using Lawton and Brody's Physical Self‐Maintenance Scale and Individual Nursing and Care Statistics. Information on physical comorbidity, number of prescribed drugs, cognitive function and formal care given was included. Dementia was diagnosed based on all information gathered. Results At all time points, toileting difficulties were more prevalent in people with than without dementia. In adjusted analyses, dementia at baseline was associated with toileting difficulties at the last assessment. Nursing home admission was associated with increased odds for toileting difficulties.

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“…Those using any collection devices were excluded (ie, response option [1]), as were those with no output (as they are suggestive of intervention such as dialysis or incorrect coding). As suggested and undertaken previously, 21 to reduce potential misclassification an a priori decision was made to collapse these response options into three categories, namely (a) continent; (b) occasionally incontinent (combining response options [2] and [3]); and (c) frequently incontinent (combining response options [4] and [5]). 21 Falls history within the last 90 days was elicited from a single question; namely, participants are asked if they have experienced a fall, with response options: (0) no fall in the last 90 days; (1) no fall in last 30 days, but fell 31 to 90 days ago; (2) one fall in last 30 days; and, (3) two or more falls in last 30 days.…”

Section: Instrument and Primary Measuresmentioning

confidence: 99%

“…As suggested and undertaken previously, 21 to reduce potential misclassification an a priori decision was made to collapse these response options into three categories, namely (a) continent; (b) occasionally incontinent (combining response options [2] and [3]); and (c) frequently incontinent (combining response options [4] and [5]). 21 Falls history within the last 90 days was elicited from a single question; namely, participants are asked if they have experienced a fall, with response options: (0) no fall in the last 90 days; (1) no fall in last 30 days, but fell 31 to 90 days ago; (2) one fall in last 30 days; and, (3) two or more falls in last 30 days. Using the falls CAP, 22 response options (0) and (1) were combined to defined a "low risk" of falls; (2) defined a "medium risk"; while (3) was used to define "high risk."…”

Section: Instrument and Primary Measuresmentioning

confidence: 99%

Urinary and fecal incontinence are independently associated with falls risk among older women and men with complex needs: A national population study

Schluter

Askew

Jamieson

et al. 2020

Neurourology and Urodynamics

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Aims To determine the relationships between urinary incontinence (UI), fecal incontinence (FI), and falls risk among community‐dwelling older women and men with complex needs, after controlling for confounders. Methods All community care recipients in New Zealand undergo standardized needs assessments, using the Home Care International Residential Assessment Instrument (interRAI‐HC), which elicits information over multiple domains, including UI and FI frequency and falls. Consenting women and men aged greater than or equal to 65 years with at least one interRAI‐HC assessment undertaken between 1 July 2012 and 1 June 2018 were investigated using multilevel mixed effects ordinal regression models, stratified by sex. Results Overall, 57 781 (61.8%) women and 35 681 (38.2%) men were eligible, contributing 138 302 interRAI‐HC assessments. At first assessment, the average age was 82.0 years (range: 65‐109 years); high falls risk was common, found among 8.8% of women and 12.4% of men; and 43.7% of women and 33.7% of men reported some incontinence. For women, the adjusted odds of increasing falls risk was 1.24 (95% CI: 1.18, 1.30) for those with occasional UI, 1.36 (95% CI: 1.29, 1.43) for those with frequent UI, and 1.19 (95% CI: 1.13, 1.26) for those with any FI compared with their continent counterparts. Among men, the adjusted odds were 1.49 (95% CI: 1.41, 1.58) for any UI and 1.18 (95% CI: 1.10, 1.27) for any FI. Conclusion UI and FI are common, have separate associations with falls risk among women and men, and would benefit from routine screening in primary health care for older adults.

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Urinary incontinence, but not fecal incontinence, is a risk factor for admission to aged residential care of older persons in New Zealand

Abstract: UI is a common, independent risk factor for ARC admissions. Identifying the extent of incontinence and its impact on ARC admissions is the first vital step in addressing the burgeoning need for better community continence services.

Cited by 32 publications

References 20 publications

Impact of urine and mixed incontinence on long-term care preference: a vignette-survey study of community-dwelling older adults

Impact of urine and mixed incontinence on long-term care preference: a vignette-survey study of community-dwelling older adults

Toileting difficulties in older people with and without dementia receiving formal in‐home care—A longitudinal study

Urinary and fecal incontinence are independently associated with falls risk among older women and men with complex needs: A national population study

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