The geriatric incontinence syndrome: Characterizing geriatric incontinence in older women.

Among older women, the clinical presentation of urinary incontinence (UI) is heterogeneous; presenting as a pelvic floor condition or geriatric syndrome. We aimed to characterize the geriatric incontinence syndrome (GIS) to establish its foundation in clinical practice.

Prospective study.

Geriatric Clinical Research Unit.

Sixty-one community-dwelling women aged 70 and older with bothersome UI symptoms.

UI symptom type and severity were determined by 3-day bladder diary. UI severity was defined; moderate UI defined as <2 UI episodes/day and severe UI defined as ≥2 UI episodes/day. Subjective assessment of physical performance was determined using the Short Physical Performance Battery (SPPB) score. Total SPPB scores >9 define normal physical performance and scores ≤9 defined impaired physical performance.

The average age was 77.1 ± 5.8 (mean ± SD) years; 69% of women had severe UI and 31% had moderate UI. Demographic characteristics were similar between groups. Daytime voiding frequency was 7.1 ± 2.9 and nocturia was present equally between groups. The majority of women (59%) with severe UI had SPPB ≤9 compared with 26% among women with moderate UI (p = 0.02); featuring significantly slower chair stand scores (2.3 ± 1.4 vs 3.3 ± 0.9, p = 0.007) and gait speed (0.08 ± 0.2 m/s compared with 1.0 ± 0.2 in women with moderate UI).

A multifactorial GIS may be present in older women evidenced by the co-existence of severe UI, physical disability, slower chair stand pace, and gait speed. Prospective studies are needed to understand how these clinical features may impact the clinical care of older incontinent women.

Journal of the American Geriatrics Society. 2021 Sep 13 [Epub ahead of print]

Candace Parker-Autry, Rebecca H Neiberg, Iris Leng, Lisa Colombo, George A Kuchel, Stephen B Kritchevsky

Department of Urology, Section on Female Pelvic Health, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA., Department of Biostatistics and Data Science, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA., Department of Physical Therapy, Wake Forest Baptist Health, Winston-Salem, North Carolina, USA., UConn Center on Aging, University of Connecticut School of Medicine, Farmington, Connecticut, USA., S.B. Kritchevsky, Sticht Center for Healthy Aging and Alzheimer's Prevention, Wake Forest School of Medicine, Winston-Salem, North Carolina, USA.