Impaired Mobility and Urinary Incontinence in Nursing Home Residents: A Multicenter Study

Abstract

PURPOSE

The purpose of this study was to evaluate associations among use of walking aids, mobility status, and occurrence of urinary incontinence (UI) in geriatric patients residing in nursing homes, and to examine associations between UI severity (frequency and amount) and its impact on health-related quality of life (QoL).

DESIGN

Multicenter descriptive cross-sectional prevalence study.

SUBJECTS AND SETTING

A total of 2044 patients from nursing homes were included in the study. A majority were female (72.0%), the mean age of participants was 82.1 years (SD 11.2), their mean body mass index was 26.1 (SD 5.4), and their mean Care Dependency Scale score was 46.0 (SD 18.2), indicating a medium to high care dependency. The study setting was 30 nursing homes throughout Germany from 2014 to 2015.

METHODS

Data were collected by trained nurses using a standardized data collection form to collect information about demographic characteristics, health conditions, mobility status measured according to the Elderly Mobility Scale (EMS), UI, and QoL measured using the International Consultation of Incontinence Questionnaire Short Form (ICIQ-SF).

RESULTS

The prevalence of UI was 69.7% (n = 1804). Analysis of variance showed that, in 1659 nursing home residents with information on UI, 572 reported a medium amount of leakage with a mean impact on health-related QoL of 2.2 (SD 2.2, P < .001) on a scale from 0 (no impact) to 10 (very high impact). The mean of the impact on QoL in 235 residents who reported a large amount of leakage was 2.4 (SD 3.0, P < .001). In 1741 residents with information on the frequency of UI, 637 reported being urinary incontinent more than once a day with a mean impact on QoL of 2.2 (SD 2.1, P < .001) and 359 residents with permanent UI stated a mean impact on QoL of 2.1 (SD 2.8, P < .001). According to the bivariate association of UI with use of walking aids, the highest prevalence of UI (61.2%) was in patients who did not use any walking aids. The Chi-square Automatic Interaction Detector (CHAID) of the relationship between mobility according to the EMS and UI indicated that 71.1% of all patients with UI did not use any walking aids, although their mobility status had been reduced.

CONCLUSIONS

Findings indicate a significant association between impaired mobility and UI in nursing home residents. Chronic, severe urinary incontinence exerted the greatest impact on health-related QoL. Therefore, we recommend measures to preserve or regain mobility to minimize or prevent UI in geriatric residents and patients and, thus, increase their health-related QoL.