Toplumda yaşayan yaşlı bireylerde ruhsal sağlık, düşmeler ve kırılganlığın gizli nedeni olarak üriner inkontinans

Abstract

Amaç: Üriner inkontinans, yaşlı bireylerde sık görülen, yaşam kalitesini azaltan ve olumsuz sağlık sonuçlarıyla ilişkili bir semptomdur. Bu çalışma, üriner inkontinansın yaygın görülen geriatrik sendromlara etkisini ve cinsiyete özgü farklılıkları değerlendirmeyi amaçlamaktadır. Gereç ve Yöntemler: Çalışmaya, 60 yaş ve üzeri, demans, nörolojik hastalık veya aktif enfeksiyonu olmayan, toplumda yaşayan bireyler dahil edilmiştir. Veriler, ayaktan polikliniklerde yapılan kapsamlı geriatri değerlendirmelerinden elde edilmiştir. Kırılganlık Fried kriterleriyle, depresyon Geriatrik Depresyon Ölçeği ile değerlendirilmiş; günlük yaşam aktivite düzeyleri, yürüme hızı, düşme öyküsü ve insomnia şikayetleri incelenmiştir. Bulgular: Çalışmaya katılan 576 bireyin 322’si (55.91) üriner inkontinans şikâyeti vardı. Kohortun ortalama yaşı 69.82±6.39du. Üriner inkontinanslı hastalarda kadın cinsiyet, obezite, kırılganlık, azalmış yürüme hızı, depresyon, düşme, insomnia ve diyabet oranları anlamlı derecede daha yüksekti (p<0.001, p=0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001 ve p=0.019). Üriner inkontinanslı kadınlar, üriner inkontinanslı erkeklere kıyasla daha fazla obezite, depresyon, azalmış yürüme hızı ve kırılganlık oranlarına sahipti (p=0.013, p<0.001, p<0.001 ve p<0.001). Çok değişkenli regresyon analizleri, üriner inkontinansın depresyon (OR: 1.59; CI: 1.06–2,38; p=0.024), insomnia (OR: 2.12; CI: 1.39–3.18; p<0.001), düşme (OR: 2.10; CI: 1.39–3.17; p<0.001) ve kırılganlık (OR: 2.42; CI: 1.66–3.54; p<0.001) olasılığını artırdığını ortaya koydu. Sonuç: Üriner inkontinans, yaşlı bireylerde, özellikle kadınlarda sık görülmekte ve depresyon, insomnia, kırılganlık ve düşmelerle ilişkilendirilmektedir. Üriner inkontinansı olan kadınlarda, erkekler ile benzer oranda uykusuzluk ve düşme gözlense de, depresyon ve kırılganlık sıklığı daha fazladır. Sağlık çalışanları, rutin değerlendirmelerde üriner inkontinansı sorgulamalı ve etkilerini yönetmelidir.

Keywords

• Üriner inkontinans
• depresyon
• insomnia
• düşme
• kırılganlık

Urinary incontinence as a hidden driver of mental health, falls, and frailty in community-dwelling older adults

Abstract

Aim: Urinary incontinence is common in older adults, significantly reducing quality of life and contributing to adverse health outcomes. This study evaluates the impact of urinary incontinence on prevalent geriatric syndromes and gender-specific differences. Material and Methods: The study included 576 community-dwelling individuals aged ≥60 years without dementia, neurological diseases, or active infections. Data were obtained retrospectively from comprehensive geriatric assessments. Frailty was assessed using Fried criteria, depression via the Geriatric Depression Scale, with additional evaluations including daily activity levels, gait speed, falls history in last year, and insomnia complaints. Results: Urinary incontinence was reported in 322 participants (55.91%). Mean age was 69.82±6.39 years. Urinary incontinence was significantly associated with female gender, obesity, frailty, reduced gait speed, depression, fall, insomnia, and diabetes (p<0.001, p=0.001, p<0.001, p<0.001, p<0.001, p<0.001, p<0.001 and p=0.019, respectively). Women with urinary incontinence had higher rates of obesity, depression, reduced gait speed, and frailty than men with urinary incontinence (p=0.013, p<0.001, p<0.001 and p<0.001, respectively). Multivariable regression analyses revealed that urinary incontinence increased the likelihood of depression (OR: 1.59; CI: 1.06–2.38; p=0.024), insomnia (OR: 2.12; CI: 1.39–3.18; p<0.001), falls (OR: 2.10; CI: 1.39–3.17; p<0.001), and frailty (OR: 2.42; CI: 1.66–3.54; p<0.001). Conclusion: Urinary incontinence is highly prevalent among older adults, particularly women, and strongly linked to depression, insomnia, frailty, and falls. Women with urinary incontinence are more likely to experience depression and frailty compared to men, despite similar rates of insomnia and falls. Routine screening and management of urinary incontinence are critical to addressing its physical and psychological impacts.

Keywords

• Urinary incontinence
• depression
• insomnia
• fall
• frailty

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