Juliebø-Jones Patrick, Coulthard Elizabeth, Mallam Elizabeth, Archer Hilary, Drake Marcus J
Bristol Brain Centre, Southmead Hospital, Bristol, UK.
Bristol Urological Institute, Southmead Hospital, Bristol, UK.
Adv Urol. 2021 Jun 19;2021:9988056. doi: 10.1155/2021/9988056. eCollection 2021.
Prevalence of urinary symptoms such as incontinence (UI) in patients with dementia is estimated to exceed 50%. The resultant psychological and socio-economic burden can be substantial. Our aim was to develop a dedicated urology service within a cognitive impairment clinic in order to treat and better understand the bothersome urinary symptoms suffered by persons with dementia.
Patients attending this clinic were invited to be assessed and interviewed by urologist, together with their family and/or carer. In addition, formal history, examination and relevant investigations, themes of importance such as quality of life, and select question items were drawn from validated questionnaires. Multidisciplinary team (MDT) meeting was carried out on the same day. Outcomes of the first 75 patients with UI and dementia have been reported.
Average age was 70 years (range 58-98). Majority of persons had a diagnosis of Alzheimer's disease ( = 43, 57%). Average score for how much urine leakage interferes with everyday life was 7.7/10 (range 2-10). 58.7% ( = 44) revealed some degree of sleep disturbance due to UI. 83% ( = 62) stated daily activities were limited due to UI. Two-thirds of persons with dementia ( = 50) stated their bladder problem makes them feel anxious. 88% ( = 67) felt the topic was socially embarrassing. All carers stated that the person's continence issues affect the care they provide. Less than one-third of carers (30.7%, = 23) were aware of or had been in contact with any bladder and bowel community service. More than half of the carers ( = 46, 65%) were concerned incontinence may be a principal reason for future nursing home admission.
UI can be distressing for persons with dementia. Care partners were concerned about loss of independence and early nursing home admission. Awareness of bladder and bowel services should be increased.
据估计，痴呆症患者中尿失禁（UI）等泌尿系统症状的患病率超过50%。由此产生的心理和社会经济负担可能相当大。我们的目标是在认知障碍诊所内建立专门的泌尿科服务，以治疗并更好地了解痴呆症患者所遭受的令人烦恼的泌尿系统症状。
邀请到该诊所就诊的患者及其家人和/或护理人员接受泌尿科医生的评估和访谈。此外，收集正式病史、进行检查及相关调查，从经过验证的问卷中提取生活质量等重要主题和特定问题项目。当天召开多学科团队（MDT）会议。已报告了首批75例尿失禁合并痴呆症患者的结果。
平均年龄为70岁（范围58 - 98岁）。大多数患者被诊断为阿尔茨海默病（n = 43，57%）。尿液泄漏对日常生活的干扰程度平均评分为7.7/10（范围2 - 10）。58.7%（n = 44）的患者因尿失禁出现某种程度的睡眠障碍。83%（n = 62）的患者表示日常活动因尿失禁而受限。三分之二的痴呆症患者（n = 50）表示膀胱问题让他们感到焦虑。88%（n = 67）的患者认为这个话题在社交场合令人尴尬。所有护理人员均表示患者的失禁问题影响了他们提供的护理。不到三分之一的护理人员（30.7%，n = 23）了解或曾接触过任何膀胱和肠道社区服务。超过一半的护理人员（n = 46，65%）担心失禁可能是未来入住养老院的主要原因。
尿失禁会给痴呆症患者带来困扰。护理伙伴担心患者失去独立性以及过早入住养老院。应提高对膀胱和肠道服务的认知。
