Fisher Steve R, Villasante-Tezanos Alejandro, Allen Lindsay M, Utsey Carolyn, Kilic Gokhan, Pappadis Monique R
Department of Physical Therapy and Rehabilitation Science, University of Texas Medical Branch at Galveston (UTMB), TX, USA.
Office of Biostatistics, University of Texas Medical Branch at Galveston (UTMB), TX, USA.
Womens Health (Lond). 2025 Jan-Dec;21:17455057251347079. doi: 10.1177/17455057251347079. Epub 2025 Jun 13.
Overactive bladder and urinary incontinence are strongly associated with falling in older adults. Despite this established link, research on how women experience these coexisting conditions is lacking.
This study aimed to better understand how older women with both urgency urinary incontinence and an increased risk of falls perceive their urinary symptoms in relation to fall risk.
Mixed-methods study using concurrent triangulation design with qualitative interviews and quantitative patient-reported outcome measures.
English-speaking women aged 60 and older with urgency or mixed urinary incontinence who screened positive for fall risk were recruited through online advertising. Fall risk was assessed using the Centers for Disease Control and Prevention's Stopping Elderly Accidents, Deaths, and Injuries "3 Key Questions." Semistructured interviews explored participants' perspectives on urinary symptoms, fall risk, and quality of life. Standardized measures included the Falls Efficacy Scale International, PROMIS Physical Function, The International Consultation on Incontinence Modular Questionnaire - Overactive Bladder symptom severity scale, The International Consultation on Incontinence Modular Questionnaire Lower Urinary Tract Symptoms Quality of Life Module, and Functional Comorbidity Index. Thematic analysis of interview transcripts was conducted using constant comparison. Multiple regression models examined associations between fear of falling, symptom severity, physical function, and urinary incontinence-related quality of life.
Sixty women responded to the online advertising for the study and completed the initial screening questionnaire. Twenty-five were enrolled and interviewed. Mean age was 68 ± 4.7. None were aware of linkages between urinary incontinence and falls. Their concerns about falling were unique to the experience of living with a urinary condition and often interacted with social stigma such as embarrassment from incontinence after a fall. Fear of falling was more strongly associated with urinary incontinence-related quality of life than symptom severity, physical functioning, or comorbid burden after adjusting for age (p < 0.01). Fear of falling and symptom severity were the only factors significantly associated with urinary incontinence-related quality of life in regression models.
There is a need to better communicate to older women with urinary incontinence the known risk of falling associated with their urinary condition.
膀胱过度活动症和尿失禁与老年人跌倒密切相关。尽管存在这种已确定的联系，但关于女性如何经历这些并存情况的研究却很缺乏。
本研究旨在更好地了解患有急迫性尿失禁且跌倒风险增加的老年女性如何看待其泌尿症状与跌倒风险的关系。
采用定性访谈和定量患者报告结局测量的并行三角测量设计的混合方法研究。
通过在线广告招募60岁及以上讲英语、患有急迫性或混合性尿失禁且跌倒风险筛查呈阳性的女性。使用疾病控制与预防中心的“预防老年人事故、死亡和伤害的3个关键问题”评估跌倒风险。半结构化访谈探讨了参与者对泌尿症状、跌倒风险和生活质量的看法。标准化测量包括国际跌倒效能量表、PROMIS身体功能量表、国际尿失禁咨询委员会膀胱过度活动症症状严重程度模块问卷、国际尿失禁咨询委员会下尿路症状生活质量模块问卷以及功能共病指数。使用持续比较法对访谈记录进行主题分析。多元回归模型检验了害怕跌倒、症状严重程度、身体功能和尿失禁相关生活质量之间的关联。
60名女性回应了该研究的在线广告并完成了初始筛查问卷。25名女性被纳入并接受访谈。平均年龄为68±4.7岁。她们均未意识到尿失禁与跌倒之间的联系。她们对跌倒的担忧在患有泌尿疾病的经历中是独特的，并且常常与社会耻辱感相互作用，例如跌倒后因失禁而感到尴尬。在调整年龄后，害怕跌倒与尿失禁相关生活质量的关联比症状严重程度、身体功能或共病负担更强（p<0.01）。在回归模型中，害怕跌倒和症状严重程度是与尿失禁相关生活质量显著相关的仅有的因素。
有必要向患有尿失禁的老年女性更好地传达与其泌尿疾病相关的已知跌倒风险。
