School of Nursing, McMaster University, Hamilton, Ontario, Canada; SE Research Centre, SE Health, Markham, Ontario, Canada; School of Public Health and Health Systems, University of Waterloo, Waterloo, Ontario, Canada.
School of Nursing, McMaster University, Hamilton, Ontario, Canada.
Can J Diabetes. 2021 Feb;45(1):47-54.e4. doi: 10.1016/j.jcjd.2020.05.005. Epub 2020 May 19.
Urinary incontinence (UI) is a burdensome condition for older adults with diabetes receiving home-care services, yet little is known about the prevalence and correlates of UI in this population. The objective of this cross-sectional study, informed by a complexity model, was to determine the prevalence and correlates of UI in older adults with diabetes receiving home care in Ontario, Canada.
In this study, we analyzed population-level data of the most recently completed Resident Assessment Instrument for Home Care from 2011 to 2016 for older (≥65 years) home-care clients with diabetes. Older adults with daily or multiple daily episodes of UI were compared with adults who were continent or had less than daily UI on sociodemographic, functional, psychosocial and clinical variables. Multiple logistic regression was used to determine correlates of UI in this population.
Of 118,519 older adults with diabetes, 39,945 (33.7%) had daily or multiple daily episodes of UI. Correlates of UI included: impaired function in activities of daily living (odds ratio [OR], 5.31; 95% confidence interval [CI], 5.14‒5.50), cognitive impairment (OR, 2.37; 95% CI, 2.28‒2.47), female sex (OR, 1.87; 95% CI, 1.82‒1.93), multiple (≥2) chronic conditions (OR, 1.83; 95% CI, 1.74‒1.93), presence of a distressed caregiver (OR, 1.31; 95% CI, 1.27‒1.35), making economic trade-offs (OR, 1.23; 95% CI, 1.11‒1.34) and falls (OR, 1.22; 95% CI, 1.19‒1.26).
Urinary incontinence is common among older adults with diabetes using home-care services. Targeted interventions are required to address the social, functional and clinical factors associated with UI in this population.
尿失禁（UI）是接受家庭护理服务的老年糖尿病患者的一种负担，但对于这一人群中 UI 的患病率和相关因素知之甚少。本横断面研究基于复杂性模型，旨在确定加拿大安大略省接受家庭护理的老年糖尿病患者中 UI 的患病率和相关因素。
在这项研究中，我们分析了 2011 年至 2016 年期间最近完成的居民家庭护理评估工具的人群水平数据，这些数据来自年龄（≥65 岁）≥65 岁）患有糖尿病的家庭护理客户。每天或多次发生 UI 的成年人与无尿失禁或每天少于一次 UI 的成年人在社会人口统计学、功能、心理社会和临床变量方面进行了比较。多变量逻辑回归用于确定该人群中 UI 的相关因素。
在 118519 名患有糖尿病的老年人中，有 39945 名（33.7%）每天或多次发生 UI。UI 的相关因素包括：日常生活活动能力受损（比值比 [OR]，5.31；95%置信区间 [CI]，5.14-5.50）、认知障碍（OR，2.37；95%CI，2.28-2.47）、女性（OR，1.87；95%CI，1.82-1.93）、多种（≥2）慢性疾病（OR，1.83；95%CI，1.74-1.93）、有苦恼的照顾者（OR，1.31；95%CI，1.27-1.35）、做出经济权衡（OR，1.23；95%CI，1.11-1.34）和跌倒（OR，1.22；95%CI，1.19-1.26）。
在使用家庭护理服务的老年糖尿病患者中，尿失禁很常见。需要针对这一人群中与 UI 相关的社会、功能和临床因素进行有针对性的干预。
