Johnson T M, Bernard S L, Kincade J E, Defriese G H
Extended Care, Atlanta VA Medical Center, USA.
J Aging Health. 2000 Feb;12(1):25-46. doi: 10.1177/089826430001200102.
The authors explored whether urinary incontinence (UI) is associated with higher mortality and, if so, whether adjustment for demographics, health, and functional status diminishes the association.
The Cox proportional hazards model was used with a nationally representative sample of community-living elderly people (N = 3,485).
In an analysis adjusted for age, gender, education, and probability sampling design, participants with mild to moderate UI (hazard ratio [HR] = 1.51; 95% confidence interval [CI] = 1.09-2.08) and severe UI (HR = 1.54; 95% CI = 1.03-2.29) experienced a higher risk of death. Adjustment for health and functional status diminished the association of UI and risk of death (mild to moderate UI, HR = 1.20, 95% CI = 0.85-1.68; severe UI, HR = 0.91, 95% CI = 0.59-1.39).
The relationship between UI and mortality in older adults can largely be understood on the basis of increased frailty in incontinent individuals.
作者探讨了尿失禁(UI)是否与更高的死亡率相关,如果是,对人口统计学、健康状况和功能状态进行调整是否会减弱这种关联。
使用Cox比例风险模型,对具有全国代表性的社区居住老年人样本(N = 3485)进行分析。
在对年龄、性别、教育程度和概率抽样设计进行调整的分析中,轻度至中度尿失禁参与者(风险比[HR] = 1.51;95%置信区间[CI] = 1.09 - 2.08)和重度尿失禁参与者(HR = 1.54;95% CI = 1.03 - 2.29)的死亡风险更高。对健康状况和功能状态进行调整后,尿失禁与死亡风险之间的关联减弱(轻度至中度尿失禁,HR = 1.20,95% CI = 0.85 - 1.68;重度尿失禁,HR = 0.91,95% CI = 0.59 - 1.39)。
老年人尿失禁与死亡率之间的关系在很大程度上可以基于失禁个体虚弱程度的增加来理解。