Evde sağlık hizmeti alan 80 yaş ve üzeri yetişkinlerde idrar kaçırma ve bunun klinik ve laboratuvar ile ilişkileri: kesitsel bir çalışma

Abstract

Amaç: İdrar kaçırma, yaşam kalitesini bozan ve yaşlı yetişkinlerde morbiditeyi artıran önemli bir halk sağlığı sorunudur. Bu çalışma, evde bakım alan 80 yaş ve üzeri hastalarda idrar kaçırmanın klinik, fonksiyonel ve laboratuvar parametreleriyle ilişkisini araştırmıştır. Yöntemler: Bu tek merkezli kesitsel çalışma, Mayıs-Kasım 2025 tarihleri arasında evde sağlık hizmeti alan bireylerle gerçekleştirilmiştir. Katılımcılar ev ziyaretleri sırasında değerlendirilmiş ve idrar kaçırma varlığına göre kategorize edilmiştir. Demografik veriler, tıbbi öykü (mevcut kronik hastalıklar ve düzenli ilaç kullanımı), beslenme durumu [Mini Beslenme Değerlendirme–Kısa Form (MNA-SF)], depresyon düzeyi [Geriatrik Depresyon Ölçeği (GDS)] ve fonksiyonel durum [Katz Günlük Yaşam Aktiviteleri İndeksi (ADL)] değerlendirilmiştir. Ayrıca çeşitli laboratuvar parametreleri kaydedilmiştir. İdrar kaçırma ile ilişkili faktörler, lojistik regresyon analizi kullanılarak belirlenmiştir. Bulgular: 135 katılımcı değerlendirildi (ortalama yaş: 85,6 ± 3,9 yıl; %61,5’i kadın). İdrar kaçırma prevalansı %34,8 olarak bulundu. Yalnız yaşama, ADL (günlük yaşam aktiviteleri) bağımlılığı, malnütrisyon, demans ve ek hastalık sayısı, idrar kaçırma olan bireylerde anlamlı şekilde daha yüksekti (p < 0,05). Bu grupta kreatinin ve CRP düzeyleri daha yüksek, demir, folat ve albümin düzeyleri ise daha düşüktü (p < 0,05). Çok değişkenli analizde yalnızca demans (OR: 5,337; p < 0,001) ve albümin (OR: 0,873; p = 0,014) bağımsız belirleyiciler olarak kaldı. ROC analizine göre, hem demans (AUC = 0,684) hem de albümin (AUC = 0,653), idrar kaçırmayı öngörmede orta derecede ayırt edici güce sahipti. Sonuç: Evde sağlık hizmeti alan yaşlı bireylerde idrar kaçırmanın, bağımsız olarak demans ve hipoalbüminemi ile ilişkili olduğu; ayrıca beslenme, fonksiyonel ve biyokimyasal faktörlerle de bağlantılı olduğu bulunmuştur. Risk faktörlerinin erken belirlenmesi, kişiselleştirilmiş bakım planlamasını destekleyebilir. Bu bulguların doğrulanması için ileri araştırmalara ihtiyaç vardır.

Keywords

• Evde Sağlık Hizmetleri
• İdrar Kaçırma
• Demans
• Günlük Yaşam Aktiviteleri
• Malnütrisyon
• Yaşlı
• 80 Yaş ve Üzeri

Urinary incontinence and its clinical and laboratory associations in adults aged 80 and over receiving home healthcare: a cross-sectional study

Abstract

Aims: Urinary incontinence is a major public health issue that impairs quality of life and increases morbidity in older adults. This study investigated its relationship with clinical, functional, and laboratory parameters in home care patients aged ≥80. Methods: This single-center, cross-sectional study was conducted between May and November 2025 with individuals receiving home care services. Participants were evaluated during home visits and categorized based on the presence of incontinence. Demographic data, medical history (including current chronic diseases and regular medication use), nutritional status [Mini Nutritional Assessment–Short Form (MNA-SF)], level of depression [Geriatric Depression Scale (GDS)], and functional status [Katz Index of Activities of Daily Living (ADL)] were assessed. Laboratory parameters were also recorded. Logistic regression identified factors independently associated with incontinence. Results: 135 participants were evaluated (mean age: 85.6±3.9 years; 61.5% female). The prevalence of incontinence was 34.8%. Living alone, ADL dependency, malnutrition, dementia, and comorbidity count were significantly higher in those with incontinence (p<0.05). Creatinine and CRP levels were higher, while iron, folate, and albumin levels were lower in this group (p<0.05). In multivariate analysis, only dementia (OR: 5.337; p<0.001) and albumin (OR: 0.873; p=0.014) remained independent predictors. ROC analysis showed modest discriminatory ability for both dementia (AUC=0.684) and albumin (AUC=0.653) in predicting incontinence. Conclusion: Urinary incontinence in older adults receiving home healthcare was found to be independently associated with dementia and hypoalbuminemia, and also related to nutritional, functional, and biochemical factors. The modest predictive performance of dementia and albumin suggests limited clinical discrimination. Early identification of high-risk individuals may enhance personalized care strategies. Future longitudinal or interventional studies are warranted to validate these findings.

Keywords

• Home care services
• urinary incontinence
• dementia
• activities of daily living
• malnutrition
• aged
• 80 and over

References

1. Al-Hamad A, Yasin YM, Metersky K, Kokorelias KM, Yasin L, Afzal F. Home healthcare services and interventions for older adults: an umbrella review of systematic reviews and meta-analyses. J Ageing Longev. 2025;5(3):25. doi:10.3390/jal5030025
2. McManus C, Oseroff BH, Zimbroff RM, Riser TJ, Ornstein KA, Sheehan OC. Shedding light on an invisible population in geriatric medicine: a scoping review of older adults who are homebound. J Am Geriatr Soc. 2025;73(11):3562-3576. doi:10.1111/jgs.19620
3. Scharp D, Harkins SE, Topaz M. Comorbidities of community-dwelling older adults with urinary incontinence: a scoping review. Geriatr Nurs. 2023;53:280-294. doi:10.1016/j.gerinurse.2023.08.005
4. Gibson W, Johnson T, Kirschner-Hermanns R, et al. Incontinence in frail elderly persons: report of the 6th International Consultation on Incontinence. Neurourol Urodyn. 2021;40(1):38-54. doi:10.1002/nau.24549
5. Ge S, Wu KC, Chien SY, Jin X, Park S, Belza B. Urinary concerns among older adults: a qualitative analysis in the context of healthy aging. BMC Geriatr. 2024;24(1):605. doi:10.1186/s12877-024-05191-y
6. Lim DS. Management of urinary incontinence in residential care. Aust Fam Physician. 2016;45(7):498-502.
7. Zheng W, Zhou C, Miao J, et al. Association between geriatric nutritional risk index and overactive bladder in the elderly population: a cross-sectional study. Front Nutr. 2025;12:1537549. doi:10.3389/fnut.2025. 1537549
8. Talley KMC, Thompson J. Lifestyle and behavioral interventions for urinary incontinence in frail older adults: an integrative review of recent evidence. Continence. 2025;13:101749. doi:10.1016/j.cont.2025.101749

9. Buck J, Fromings Hill J, Collins R, Booth J, Fleming J. Effectiveness of non-pharmacological interventions delivered at home for urinary and faecal incontinence with homebound older people: systematic review of randomised controlled trials. Age Ageing. 2024;53(6):afae126. doi:10. 1093/ageing/afae126
10. Arik G, Varan HD, Yavuz BB, et al. Validation of Katz Index of independence in activities of daily living in Turkish older adults. Arch Gerontol Geriatr. 2015;61(3):344-350. doi:10.1016/j.archger.2015.08.019
11. Sarikaya D, Halil M, Kuyumcu ME, et al. Mini nutritional assessment test long and short form are valid screening tools in Turkish older adults. Arch Gerontol Geriatr. 2015;61(1):56-60. doi:10.1016/j.archger.2015.04.006
12. Ertan T, Eker E. Reliability, validity, and factor structure of the geriatric depression scale in Turkish elderly: are there different factor structures for different cultures? Int Psychogeriatr. 2000;12(2):163-172. doi:10.1017/s1041610200006293
13. Brown JS, Bradley CS, Subak LL, et al. The sensitivity and specificity of a simple test to distinguish between urge and stress urinary incontinence. Ann Intern Med. 2006;144(10):715-723. doi:10.7326/0003-4819-144-10-200605160-00005
14. Institute TS. Elderly statistics, 2024 (Press Release No: 54079). TurkStat. Updated March 13. Accessed Nov 23, 2025. https://data.tuik.gov.tr
15. Chawla K, Kunonga TP, Stow D, Barker R, Craig D, Hanratty B. Prevalence of loneliness amongst older people in high-income countries: a systematic review and meta-analysis. PLoS One. 2021;16(7):e0255088. doi:10.1371/journal.pone.0255088
16. Pollak C, Pham Y, Ehrlich A, Verghese J, Blumen HM. Loneliness and social isolation risk factors in community-dwelling older adults receiving home health services. BMC Geriatr. 2025;25(1):290. doi:10. 1186/s12877-025-05947-0
17. Beck RA, Arizmendi A, Purnell C, Fultz BA, Callahan CM. House calls for seniors: building and sustaining a model of care for homebound seniors. J Am Geriatr Soc. 2009;57(6):1103-9. doi:10.1111/j.1532-5415.2009.02278.x
18. Alptekin D, Şişman H, Akpolat R, Gezer D, Gökçe E, Arslan S. Evaluation of chronic pain management in the elderly living in a nursing home assessment of age and chronic pain. MBSJOHS. 2022;8(4):615-623. doi:10.19127/mbsjohs.1148946
19. Ates Bulut E, Soysal P, Isik AT. Frequency and coincidence of geriatric syndromes according to age groups: single-center experience in Turkey between 2013 and 2017. Clin Interv Aging. 2018;13:1899-1905. doi:10. 2147/CIA.S180281
20. Çulha Y, Yildirim S, Büyükyılmaz F. Awareness of urinary incontinence and its relationship with health-seeking behavior among older adults living in nursing homes. Kocatepe Med J. 2023;25:194-200. doi:10.18229/kocatepetip.1276132
21. Jerez-Roig J, Farres-Godayol P, Yildirim M, et al. Prevalence of urinary incontinence and associated factors in nursing homes: a multicentre cross-sectional study. BMC Geriatr. 2024;24(1):169. doi:10.1186/s12877-024-04748-1
22. Murphy C, De Laine C, Macaulay M, Hislop Lennie K, Fader M. Problems faced by people living at home with dementia and incontinence: causes, consequences and potential solutions. Age Ageing. 2021;50(3):944-954. doi:10.1093/ageing/afaa262
23. Mousavi Nasab MM, Khavandegar A, Fakhrzadeh H, et al. Exploring the relationship among malnutrition, intake of various food groups, and sarcopenia in elderly population: a cross-sectional analysis. Health Sci Rep. 2025;8(8):e71058. doi:10.1002/hsr2.71058
24. Kido Y, Yoshimura Y, Wakabayashi H, et al. Improvement in sarcopenia is positively associated with recovery of independence in urination and defecation in patients undergoing rehabilitation after a stroke. Nutrition. 2023;107:111944. doi:10.1016/j.nut.2022.111944
25. Jiang Y, Yang Z, Wu Q, Cao J, Qiu T. The association between albumin and C-reactive protein in older adults. Medicine (Baltimore). 2023; 102(34):e34726. doi:10.1097/MD.0000000000034726
26. Birder L, Andersson KE. Urothelial signaling. Physiol Rev. 2013;93(2): 653-680. doi:10.1152/physrev.00030.2012
27. Bauer SR, Scherzer R, Zhao S, et al. Association of lower urinary tract symptom severity with kidney function among community dwelling older men. J Urol. 2020;204(6):1305-1311. doi:10.1097/JU. 0000000000001310