The Impact of Urinary Incontinence on Older Women’s Life

Urinary Incontinence (UI) is defined as accidently leaking of urine at an inappropriate time and in an inappropriate place and is associated with reduced quality of life for older adults. It is common in aging women and it is not surprising to consider that UI is an integral part of many diseases. Symptoms of UI has been classified as stress, urge, mixed, overflow, continuous type and others. Stress UI is when people leak urine by coughing, sneezing, laughing, heavy lifting and exercising. Urge UI is overactive bladder that people are not able to delay going to the toilet. Mixed UI is combination of stress and urge UI, and overflow UI is constant leaking form full bladder. Epidemiological studies organized that UI is showed 2-3 times more common in older women and the condition is observed different from cultures and races. However, some statistics addressed that UI is indicated to all older population regardless of region. Even though UI is not life-threatening, it can impact negatively on physical, social and emotional problem and sexual life among older adults. Patients have felt shame, anger, sadness, as well as embarrassment about their UI, which leads them isolate themselves from friends and family. As patients have tried to avoid doing physical exercise, going public place and hanging out with their family, UI increase the risk of osteoporosis, hypertension, loneliness and depression.

Treatments include behavioral, pharmacological and surgical interventions. Hence, the purpose of this research paper is to analyze how urinary incontinence (UI) affect older women’s life by examining cross-sectional and longitudinal studies. Empirical 1Observational research is a type of correlational research in which a researcher observes ongoing behavior. Nazli Seonsoy is family medicine staff, Nurhan Dogan is Biostatistics, and burcu Ozek and Leyla Karaaslan are 6 th greade medical student at Afyon Kocatepe University. They wrote “Urinary incontinence in women: prevalence rates, risk factors and impact on quality of life” (2013;29(3):818-822). They have studied to conclude the prevalence, risk factors of UI and to evaluate its impact on the quality of women’s life. Total 1050 female participants are involved, and their age is from 20 to 80 years old. All of them are referred to the outpatient of Kocatepe University Hospital between December 2009 and January 2010. This research is cross sectional study and handled on questionnaire which examines the type, severity of UI, and impact of quality of life. Before starting the survey, they provided informed consent to the participants, and investigators did face to face interview for only the illiterate participants. The data is collected the comparisons of prevalence between the dichotomous categories in which is made using the chi-square tests.

To evaluate the possible risk factors of UI the epidemiological data were examined with the binary logistic regression models. UI (positive or negative) was the dependent variable, while menopause, constipation, hypertension, diabetes mellitus, family history of urinary leakage and the number of deliveries were independent variables in the logistic regression. All analyses were conducted using the SPSS (Statistical Package for the Social Science) for Windows. The comparison of women with or without UI, the important differences were found in terms of socio-demographic characteristics. In an age-group, 40-49 old years, in marital status, married, in occupation, housewife and in body mass index, 30 women are higher risk of UI. Also, menopausal women are more three times higher than non-menopausal, and a family history of UI was two times higher than the others. They also found that half of women did not admit hospital regarded this condition because they are feeling humiliated of being examined, not feeling uncomfortable UI, and no time to go examination. Finally, authors concluded that UI affects women’s life negatively and related to importantly to age, education, occupation, marital status and BMI. However, many women do not go health clinic because of social, psychological and cultural problems. Therefore, healthcare professionals should consider improving the awareness of this problem among women and should provide medical and psychosocial care.

Furthermore, experimental research is defined as quantitative research in which variables are held constantly while the other variables are being measured as the subjects of experiment. according to the research paper, “Living with urinary incontinence: a longitudinal study of older women”, indicates that UI is relevant to body weight and constipation among older women. Julie Byles is co-director of the HMRI (Hunter Medical Research Institute) and director of Research Centre for gender, health and ageing, school of medicine and public health at the University of Newcastle in Australia. David Sibbritt is professor of epidemiology and Biostatistics, and Pauline Chiarelli is a senior lecturer physiotherapy at University of Newcastle. They aimed to find UI status among a large cohort of women, and to analyze factors that associated with conditions in later life. The participants were from the oldest cohort of ALSWH (Australian Longitudinal Study of Women’s Health) and 70-75 years old. The survey was started in April 1996 and the women were randomly sampled form the Australian universal health insurance database. The longitudinal research conducted by collecting data over 10 years at 3-years gap from the ALSWH. The procedure was done by questionnaire that had been asked ‘never’, ‘rarely’, ‘sometimes’ or ‘often’ at the last 12 months. Moreover, BMI (body mass index) was measured from self-report. Other variables employed to examine social conditions that include the area of residence as well as educations, marital status and daily tasks. The data was collected by using SAS V9. 1 (Statistical Analysis System).

In these examinations, the dependent variable was the leaking urine at each inquiry, and explanatory variables were health and social factors. For the data of women who died or withdrew during the survey were used GEE (Generalized Estimating Equation) models. They found that the most women have experienced leaking urine often or sometimes. UI is highly associated with physical conditions such as dementia, physical ability, falls to the ground, BMI, constipation, urinary tract infection. However, educations, area of residence, smoking or attending social groups are not relevant to UI. Hence, BMI, dysuria and constipation are major key to prevent UI among older women and considerable costs for health care systems.