Urinary Incontinence Severity, Depression and Anxiety Relation in Osteoporosis Patients

Abstract

Amaç: Osteoporozlu hastalarda üriner inkontinansı (Üİ) şiddeti ile depresyon, anksiyete ve yaşam kalitesi arasındaki ilişkinin değerlendirilmesi amaçlandı. Gereç ve Yöntem: Olguların dual enerji X-ray absorbsiyometre yöntemiyle lomber vertebra ve femur boyun bölgelerinden yapılan kemik mineral yoğunluğu (KMY) ölçüm sonuçlarına göre, KMY değerleri -1 ile -2,5 standart sapma (SS) arasında tespit edilenler osteopeni (n=39); -2,5 SS ve yüksek değerler Osteoporoz (n=37), KMY değerleri -1 SS'den düşük ve herhangi bir hastalık öyküsü olmayanlar kontrol grubu (n=37) olarak değerlendirildi. Tüm katılımcılara sosyo-demografik veri formu, İnkontinans Şiddet indeksi (İŞİ), Yaşam Kalitesi ölçeği (SF-36), Beck Depresyon envanteri (BDE) ve Beck Anksiyete envanteri (BAE) uygulandı. Bulgular: Gruplar arasında İŞİ açısından kontrol grubu ile osteoporoz grubu arasında ve osteoporoz grubuyla osteopeni grubu arasında, osteoporozlu grupta yüksek olacak şekilde, anlamlı farklılık vardı. İŞİ skoru arttıkça BDE ve BAE skorları artmakta idi. İŞİ skoru ile yaşam kalitesinin alt ölçekleri arasında ilişki saptanamadı. Sonuç: Osteoporozlu hastalarda Üİ sık görülen bir durumdur ve KMY azaldıkça Üİ şiddeti artmaktadır. Hem osteoporoz, hem Üİ yüksek oranda depresyon ve anksiyeteye neden olabilmektedir. Osteoporozlu hastalarda Üİ varlığı, şiddeti, depresyon ve anksiyete durumunun sorgulanması, osteoporoz yönetimine katkıda bulunacaktır. Objective:The present study aimed to analyze the relation between urinary incontinence (UI) severity and depression, anxiety and quality of life in osteoporosis patients. Materials and Methods: Based on the bone mineral density (BMD) measurements conducted on the lumbar vertebra and femoral neck regions with dual-energy X-ray absorptiometry, those with BMD values between -1 and -2.5 standard deviation (SD) were considered as osteopenia patients (n=39), those with -2.5 SD or higher values were considered as osteoporosis patients (n=37), and those with BMD values lower than -1 SD and without any disease history were determined as the control group (n=37). Socio-demographic data form, Incontinence Severity index (ISI), Quality of Life scale (SF-36), Beck Depression inventory (BDI), and Beck Anxiety inventory (BAI) were applied to all participants. Results: It was determined that there were significant differences between the control group and the osteoporosis group, and between the osteoporosis group and the osteopenia group based on ISI scores, which was higher in the osteoporosis group. As the ISI score increased, BDI and BAI scores increased as well. There was no correlation between ISI score and quality of life subscales. Conclusion: UI is a common condition among osteoporosis patients and the severity of UI increases with a decrease in BMD. Both osteoporosis and UI could lead to high level of depression and anxiety. The investigation of the presence and severity of UI, questioning of the depression and anxiety in osteoporosis patients would contribute to the management of the disease.

Coexistence of Urinary Incontinence and Osteoporosis in Females – A Systematic Review

“…The OP group and the healthy group scores were statistically significant in terms of presence of UI (p-value <0.001) in comparison to osteopenic and healthy group scores (pvalue =0.081). Even the OP and osteopenic group scores also showed statistically significant difference (p-value <0.001) [18]. UI risk was 1.79 times greater in women with OP than in women without osteopenia, regardless of age, according to a retrospective cohort analysis.…”

“…The studies included were carried out in four nations: Turkey, USA, Korea, China (Table 1). Most of the papers [15,16,17] were cross-sectional in nature, with one retrospective cohort study [12] and one correlation study [18]. Only women were included in all the studies.…”

“…Majority of the research looked at women between the ages of 40 to 70. All five studies [12,[15][16][17][18] (100.0%) described age, body mass index, race, mode of delivery, smoking and drinking status of participants while few also focused on previous health condition, or surgery, physical activity, marital status and previous fractures. The majority of research used questionnaires to track UI prevalence, with only a handful relying on self-reporting (Table 1).…”

“…BMD of -1 to -2.5 Standard deviation (S.D.) were classified as having osteopenia, while those with a BMD of -2.5 and below were classified as having OP [15,17,18]. Trabecular bone scan (TBS) and fracture risk classification scheme was used in one of the studies by Isuzu Meyer et al TBS of ≤ 1.31 suggested decreased bone quality, indicating a moderate to high risk of fracture [15].…”

“…while the three Incontinence Questions (3IQ) were used to determine the kinds of UI among participants [15,17]. Ejder Berk et al assessed the frequency and amount of urine loss by another instrument known as Incontinence Severity Index [18] while as the International Consultation on Incontinence Questionnaire was used to assess the frequency and severity of UI by Richter et al [17]. Face-to-face interview was the method of investigation used to assess UI by Ji Hyun Moon et al [16].…”