1 Icahn School of Medicine at Mount Sinai , New York, New York.
2 Department of Medicine, University of California San Francisco , San Francisco, California.
J Womens Health (Larchmt). 2018 Sep;27(9):1097-1103. doi: 10.1089/jwh.2017.6891. Epub 2018 Jun 14.
Urinary incontinence (UI) can interfere with older women's ability to perform activities of daily living (ADLs), but little is known about factors that predispose incontinent women to become functionally dependent or compromise their ability to serve as caregivers to others.
UI, caregiving, and care-receiving behaviors were assessed by questionnaire in a national sample of community-dwelling older women. Multivariable models evaluated associations between incontinence and care dependence, assessed factors associated with care dependence among incontinent women, and compared health among female caregivers with and without incontinence.
Of the 1703 women, 27% reported weekly or more incontinence and 13% monthly incontinence. Women with weekly or more incontinence were more likely than women without incontinence to report receiving care for ADLs (AOR = 2.39, CI = 1.61-3.56) or instrumental ADLs (AOR = 1.94, CI = 1.42-2.63). Compared to 46% of women without incontinence, 60% of women with monthly or weekly incontinence reported unmet care needs (p = 0.0002). Factors associated with care dependence included more frequent incontinence, older age, marital status, and fair/poor health (p < 0.05 for all). Overall, 15% of women served as a caregiver for another adult, which did not differ by incontinence status (p = 0.84), but female caregivers with incontinence reported worse health than those without incontinence (p = 0.0004).
In this national cohort, older women with incontinence were more likely to be functionally dependent and have unmet care needs than those without incontinence, after adjustment for other factors. At least one in ten incontinent women served as caregivers, despite having worse health than female caregivers without incontinence.
尿失禁（UI）会影响老年女性进行日常生活活动（ADLs）的能力，但对于哪些因素会使失禁女性更容易依赖他人或损害其照顾他人的能力知之甚少。
通过问卷调查评估了全国社区居住的老年女性人群中尿失禁、照顾和接受照顾行为。多变量模型评估了尿失禁与依赖照顾之间的关联，评估了尿失禁女性中与依赖照顾相关的因素，并比较了有尿失禁和无尿失禁的女性照顾者的健康状况。
在 1703 名女性中，27%的人每周或更多次失禁，13%的人每月失禁。每周或更多次失禁的女性比没有失禁的女性更有可能报告接受 ADLs（AOR=2.39，CI=1.61-3.56）或工具性 ADLs（AOR=1.94，CI=1.42-2.63）的照顾。与 46%没有失禁的女性相比，60%每月或每周失禁的女性报告存在未满足的照顾需求（p=0.0002）。与依赖照顾相关的因素包括更频繁的失禁、年龄较大、婚姻状况和健康状况一般或较差（所有因素 p<0.05）。总体而言，15%的女性为另一名成年人提供照顾，但失禁状况无差异（p=0.84），但有失禁的女性照顾者的健康状况比没有失禁的女性差（p=0.0004）。
在这个全国性队列中，调整其他因素后，与没有失禁的女性相比，有失禁的老年女性更有可能依赖他人，且有未满足的照顾需求。尽管有失禁的女性照顾者的健康状况比没有失禁的女性照顾者差，但至少有十分之一的失禁女性担任照顾者。
