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Demans Hastalarında Üriner İnkontinans ve Sarkopeni İlişkisi

Year 2022, Volume: 5 Issue: 2, 107 - 115, 31.08.2022
https://doi.org/10.36516/jocass.1117649

Abstract

Amaç: Demans, sarkopeni ve üriner inkontinans (Üİ) sık görülen geriatrik sendromlardır. Üİ, yaşam kalitesini etkileyen, sosyal izolasyon ile sonuçlanan, düşmeye ve düşmeye bağlı morbidite ve mortaliteye de sebep olan bir durumdur. Ayrıca demans hastalarında bakım yükünü ve bakım veren tükenmişliğini artırır. Kontinans için sağlam bir genito-üriner sistem, periferik ve santral sinir sistemi ve de biliş gerekmektedir. Bunun yanında çizgili kas grubundan pelvik taban kaslarının ve iskelet sisteminin de kontinanstaki önemi göz ardı edilemez. Çalışmamızda demans hastalarında Üİ ile sarkopeni arasındaki ilişkiyi değerlendirmeyi planladık.
Materyal ve Metot: Ocak 2015 ve Aralık 2021 tarihleri arasında Dokuz Eylül Üniversitesi Geriatri birimine başvuran sarkopeni değerlendirmesi olan demans hastaları çalışmaya dahil edilmiştir. Hastalar Üİ durumlarına göre iki gruba ayrılmıştır. Sarkopeni tanısı EWGSOP-2 kriterleri kullanılarak konulmuştur.
Bulgular: Gruplar arasında demografik veriler ve laboratuvar bulgularında anlamlı farklılık saptanmadı. Depresyon ve anti-parkinson ilaç kullanımı Üİ grubunda daha sıktı. Üİ grubunda muhtemel sarkopeni, ciddi sarkopeni, düşük yürüme hızı ve kırılganlık sıklığı daha yüksek; temel günlük yaşam aktivite skoru daha düşük bulundu (p <0,050). Regresyon analizi yapıldığında Üİ; muhtemel sarkopeni, ciddi sarkopeni ve düşük yürüme hızı ile ilişkili bulundu (OR:1,854, %95 CI 1,107-3,106; OR:2,152, %95 CI 1,193-7,360; Or:3,065, %95 CI 1,726 –5,443).
Sonuç: Demansın küratif tedavisinin olmaması nedeniyle eşlik eden komorbid durumların tedavisi ve önlenmesi büyük önem kazanmaktadır. Yaşam kalitesinin artması ve bakım yükünün azaltılmasında Üİ ile mücadele önemlidir. Sarkopeni ve Üİ ilişkisinin akılda tutulması ve buna yönelik girişimler faydalı olabilir.
Anahtar kelimeler: Demans, sarkopeni, üriner inkontinans.

Supporting Institution

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References

  • 1. Melo LS de, Ercole FF, Oliveira DU de, Pinto TS, Victoriano MA, Alcoforado CLGC. Urinary tract infection: a cohort of older people with urinary incontinence. Rev Bras Enferm. 2017;70(4):838-844. doi:10.1590/0034-7167-2017-0141
  • 2. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(4):601-602.. doi:10.1093/ageing/afy169
  • 3. Ontan MS, Dokuzlar O, Ates Bulut E, Soysal P, Isik AT. The relationship between osteoporosis and sarcopenia, according to EWGSOP-2 criteria, in outpatient elderly. J Bone Miner Metab. 2021;39(4):684-692. doi:10.1007/s00774-021-01213-6
  • 4. Ida S, Kaneko R, Nagata H, et al. Association between Sarcopenia and Overactive Bladder in Elderly Diabetic Patients. Journal of Nutrition, Health and Aging. 2019;23(6):532-537. doi:10.1007/S12603-019-1190-1
  • 5. Ates Bulut E, Soysal P, Isik AT. Frequency and coincidence of geriatric syndromes according to age groups: single-center experience in Turkey between 2013 and 2017. Clin Interv Aging. 2018;13:1899-1905. doi:10.2147/CIA.S180281
  • 6. Tish MM, Geerling JC. The Brain and the Bladder: Forebrain Control of Urinary (In)Continence. Frontiers in Physiology. 2020;11:658. doi:10.3389/FPHYS.2020.00658
  • 7. Philip Y and Tan D. Urinary incontinence in dementia: a practical approach | Australian Family Physician. 2006: 35(4). https://search.informit.org/doi/abs/10.3316/informit.364281255901965
  • 8. Luber KM, Boero S, Choe JY. The demographics of pelvic floor disorders: current observations and future projections. Am J Obstet Gynecol. 2001;184(7):1496-1503. doi:10.1067/MOB.2001.114868
  • 9. Dost FS, Ates Bulut E, Dokuzlar O, et al. Sarcopenia is as common in older patients with dementia with Lewy bodies as it is in those with Alzheimer’s disease. Geriatr Gerontol Int. 2022;22(5):418-424. doi:10.1111/ggi.14383
  • 10. Burns JM, Johnson DK, Watts A, Swerdlow RH, Brooks WM. Reduced lean mass in early Alzheimer disease and its association with brain atrophy. Arch Neurol. 2010;67(4):428-433. doi:10.1001/archneurol.2010.38
  • 11. Idil E, Aydin AE, Ates Bulut E, Isik AT. Rationally decreasing the number of drugs seems to be a useful therapeutic approach in older adults: 6-month follow-up study. Arch Gerontol Geriatr. 2021;96:104472. doi:10.1016/j.archger.2021.104472
  • 12. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146-156. doi:10.1093/gerona/56.3.m146
  • 13. American Psychiatric Association. DSM-5 Diagnostic Classification. In: Diagnostic and Statistical Manual of Mental Disorders. ; 2013. doi:10.1176/appi.books.9780890425596.x00diagnosticclassification
  • 14. Roberts HC, Denison HJ, Martin HJ, et al. A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach. Age Ageing. 2011;40(4):423-429. doi:10.1093/ageing/afr051
  • 15. Ates Bulut E, Soysal P, Dokuzlar O, et al. Validation of population-based cutoffs for low muscle mass and strength in a population of Turkish elderly adults. Aging Clin Exp Res. 2020;32(9):1749-1755. doi:10.1007/s40520-019-01448-4
  • 16. Resnick N, Medicine SYNEJ. Management of urinary incontinence in the elderly. New England Journal of Medicine. 1985;313(13):800-805. https://www.nejm.org/doi/pdf/10.1056/NEJM198509263131307
  • 17. Staskin DR.Age-related physiologic and pathologic changes affecting lower urinary tract function. Clinics in Geriatric Medicine. 1986; 2(4): 701-710. https://pubmed.ncbi.nlm.nih.gov/3536058/
  • 18. Duffin HM, Asher MJ. Clinical and urodynamic studies in 100 elderly incontinent patients. British Medical Journal (Clinical research ed). 1981;282(6270):1103-1105. doi:10.1136/bmj.282.6270.1103
  • 19. Yu LC, Rohner TJ, Kaltreider DL, Hu T ‐w, Igou JF, Dennis PJ. Profile of Urinary Incontinent Elderly in Long‐Term Care Institutions. J Am Geriatr Soc. 1990;38(4):433-439. doi:10.1111/j.1532-5415.1990.tb03542.x
  • 20. Jirovec MM, Wells TJ. Urinary incontinence in nursing home residents with dementia: The mobility-cognition paradigm. Applied Nursing Research. 1990;3(3):112-117. doi:10.1016/S0897-1897(05)80126-0
  • 21. Jewett MAS, Fernıe GR, Hollıday PJ, Pım ME. Urinary Dysfunction in a Geriatric Long‐Term Care Population: Prevalence and Patterns. J Am Geriatr Soc. 1981;29(5):211-214. doi:10.1111/j.1532-5415.1981.tb01768.x
  • 22. McLaren SM. Prevalence and severity of incontinence among hospitalised female female psychogeriatric patients." Health Bull 39 (1981): 157-161.https://pubmed.ncbi.nlm.nih.gov/term=Prevalence+and+severity+of+incontinence+among+hospitalised%2C+&filter=datesearch.y_5
  • 23. Borrie MJ, Davidson HA. Incontinence in institutions: Costs and contributing factors. CMAJ. 1992;147(3):322-328.
  • 24. Schnelle JF, MacRae PG, Ouslander JG, Simmons SF, Nitta M. Functional Incidental Training, Mobility Performance, and Incontinence Care with Nursing Home Residents. J Am Geriatr Soc. 1995;43(12):1356-1362. doi:10.1111/j.1532-5415.1995.tb06614.x
  • 25. Waite SJ, Maitland S, Thomas A, Yarnall AJ. Sarcopenia and frailty in individuals with dementia: A systematic review. Archives of Gerontology and Geriatrics. 2021;92. doi:10.1016/j.archger.2020.104268
  • 26. Moon Y, Moon WJ, Kim JO, Kwon KJ, Han SH. Muscle Strength Is Independently Related to Brain Atrophy in Patients with Alzheimer’s Disease. Dementia and Geriatric Cognitive Disorders. 2019;474-6):306-314. doi:10.1159/000500718
  • 27. Burns JM, Johnson DK, Watts A, Swerdlow RH, Brooks WM. Reduced lean mass in early Alzheimer disease and its association with brain atrophy. Arch Neurol. 2010;67(4):428-433. doi:10.1001/ARCHNEUROL.2010.38
  • 28. Chong MS, Tay L, Ismail NH, et al. The Case for Stage-Specific Frailty Interventions Spanning Community Aging to Cognitive Impairment. J Am Med Dir Assoc. 2015;16(11):1003.e13-1003.e19. doi:10.1016/J.JAMDA.2015.08.025
  • 29. Silva RRL, Coutinho JFV, Vasconcelos CTM, et al. Prevalence of sarcopenia in older women with pelvic floor dysfunction. Eur J Obstet Gynecol Reprod Biol. 2021;263:159-163. doi:10.1016/J.EJOGRB.2021.06.037
  • 30. Mutlay F, ERKEN N, Günay FSD, Kaya D, Isik AT. Yaşlılarda Depresyon Düşme Sıklığı ile İlişkilendirilebilir mi? Geriatrik Bilimler Dergisi. 2020; 3(3):103-109 doi:10.47141/geriatrik.826378
  • 31. Heijnen WTCJ, Kamperman AM, Tjokrodipo LD, Hoogendijk WJG, van den Broek WW, Birkenhager TK. Influence of age on ECT efficacy in depression and the mediating role of psychomotor retardation and psychotic features. Journal of Psychiatric Research. 2019;109:41-47. doi:10.1016/J.JPSYCHIRES.2018.11.014
  • 32. von Coelln R, Dawe RJ, Leurgans SE, et al. Quantitative mobility metrics from a wearable sensor predict incident parkinsonism in older adults. Parkinsonism & Related Disorders. 2019;65:190-196. doi:10.1016/J.PARKRELDIS.2019.06.012
  • 33. Stanaway FF, Gnjidic D, Blyth FM, et al. How fast does the Grim Reaper walk? Receiver operating characteristics curve analysis in healthy men aged 70 and over. BMJ. 2011;343:d7679. doi:10.1136/bmj.d7679

The Relationship Between Urinary Incontinence and Sarcopenia in Patients with Dementia

Year 2022, Volume: 5 Issue: 2, 107 - 115, 31.08.2022
https://doi.org/10.36516/jocass.1117649

Abstract

Aim: Dementia, sarcopenia, and urinary incontinence (UI) are common geriatric syndromes. UI is a condition that affects the quality of life, results in social isolation, causes falls and, causes morbidity and mortality due to falls. UI also increases caregiver burnout and the burden of care in dementia patients. Continence requires an intact genito-urinary system, peripheral and central nervous system, and cognitive health. In addition, the importance of the pelvic floor muscles from the striated muscle group and the skeletal system in continence cannot be ignored. In the light of these facts, we aimed to evaluate the relationship between UI and sarcopenia in patients with dementia.
Materials and Method: Dementia patients with sarcopenia who applied to the DEU Geriatrics unit between January 2015 and December 2021 were included. Patients with CDR 3 dementia and those with acute problems were excluded. Patients were grouped according to their UI status and evaluated for sarcopenia using the EWGSOP-2 criteria.
Results: According to the presence of UI, no significant difference was found in demographic and laboratory findings between groups. The frequency of anti-parkinsonian drug usage and depression was more common in the UI group. While, the frequency of probable sarcopenia, severe sarcopenia, slow gait speed, and frailty was higher in the UI group; Barthel's score was lower (p <0.050, for each). After regresion analysis, UI was associated with probable sarcopenia, severe sarcopenia, and slow gait speed (OR: 1.854, 95% CI 1.107-3.106; OR: 2.152, 95% CI 1.193-7.360; OR: 3.065, 95% CI 1.726 –5.443, respectively).
Conclusion: Due to the lack of proven treatment for dementia itself, the treatment and prevention of comorbidities have great importance. Treatment of UI is important in increasing the quality of life and reducing the burden of care. The relationship between sarcopenia and UI should be kept in mind. Moreover, interventions for sarcopenia may be beneficial for UI.

References

  • 1. Melo LS de, Ercole FF, Oliveira DU de, Pinto TS, Victoriano MA, Alcoforado CLGC. Urinary tract infection: a cohort of older people with urinary incontinence. Rev Bras Enferm. 2017;70(4):838-844. doi:10.1590/0034-7167-2017-0141
  • 2. Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(4):601-602.. doi:10.1093/ageing/afy169
  • 3. Ontan MS, Dokuzlar O, Ates Bulut E, Soysal P, Isik AT. The relationship between osteoporosis and sarcopenia, according to EWGSOP-2 criteria, in outpatient elderly. J Bone Miner Metab. 2021;39(4):684-692. doi:10.1007/s00774-021-01213-6
  • 4. Ida S, Kaneko R, Nagata H, et al. Association between Sarcopenia and Overactive Bladder in Elderly Diabetic Patients. Journal of Nutrition, Health and Aging. 2019;23(6):532-537. doi:10.1007/S12603-019-1190-1
  • 5. Ates Bulut E, Soysal P, Isik AT. Frequency and coincidence of geriatric syndromes according to age groups: single-center experience in Turkey between 2013 and 2017. Clin Interv Aging. 2018;13:1899-1905. doi:10.2147/CIA.S180281
  • 6. Tish MM, Geerling JC. The Brain and the Bladder: Forebrain Control of Urinary (In)Continence. Frontiers in Physiology. 2020;11:658. doi:10.3389/FPHYS.2020.00658
  • 7. Philip Y and Tan D. Urinary incontinence in dementia: a practical approach | Australian Family Physician. 2006: 35(4). https://search.informit.org/doi/abs/10.3316/informit.364281255901965
  • 8. Luber KM, Boero S, Choe JY. The demographics of pelvic floor disorders: current observations and future projections. Am J Obstet Gynecol. 2001;184(7):1496-1503. doi:10.1067/MOB.2001.114868
  • 9. Dost FS, Ates Bulut E, Dokuzlar O, et al. Sarcopenia is as common in older patients with dementia with Lewy bodies as it is in those with Alzheimer’s disease. Geriatr Gerontol Int. 2022;22(5):418-424. doi:10.1111/ggi.14383
  • 10. Burns JM, Johnson DK, Watts A, Swerdlow RH, Brooks WM. Reduced lean mass in early Alzheimer disease and its association with brain atrophy. Arch Neurol. 2010;67(4):428-433. doi:10.1001/archneurol.2010.38
  • 11. Idil E, Aydin AE, Ates Bulut E, Isik AT. Rationally decreasing the number of drugs seems to be a useful therapeutic approach in older adults: 6-month follow-up study. Arch Gerontol Geriatr. 2021;96:104472. doi:10.1016/j.archger.2021.104472
  • 12. Fried LP, Tangen CM, Walston J, et al. Frailty in older adults: evidence for a phenotype. J Gerontol A Biol Sci Med Sci. 2001;56(3):M146-156. doi:10.1093/gerona/56.3.m146
  • 13. American Psychiatric Association. DSM-5 Diagnostic Classification. In: Diagnostic and Statistical Manual of Mental Disorders. ; 2013. doi:10.1176/appi.books.9780890425596.x00diagnosticclassification
  • 14. Roberts HC, Denison HJ, Martin HJ, et al. A review of the measurement of grip strength in clinical and epidemiological studies: towards a standardised approach. Age Ageing. 2011;40(4):423-429. doi:10.1093/ageing/afr051
  • 15. Ates Bulut E, Soysal P, Dokuzlar O, et al. Validation of population-based cutoffs for low muscle mass and strength in a population of Turkish elderly adults. Aging Clin Exp Res. 2020;32(9):1749-1755. doi:10.1007/s40520-019-01448-4
  • 16. Resnick N, Medicine SYNEJ. Management of urinary incontinence in the elderly. New England Journal of Medicine. 1985;313(13):800-805. https://www.nejm.org/doi/pdf/10.1056/NEJM198509263131307
  • 17. Staskin DR.Age-related physiologic and pathologic changes affecting lower urinary tract function. Clinics in Geriatric Medicine. 1986; 2(4): 701-710. https://pubmed.ncbi.nlm.nih.gov/3536058/
  • 18. Duffin HM, Asher MJ. Clinical and urodynamic studies in 100 elderly incontinent patients. British Medical Journal (Clinical research ed). 1981;282(6270):1103-1105. doi:10.1136/bmj.282.6270.1103
  • 19. Yu LC, Rohner TJ, Kaltreider DL, Hu T ‐w, Igou JF, Dennis PJ. Profile of Urinary Incontinent Elderly in Long‐Term Care Institutions. J Am Geriatr Soc. 1990;38(4):433-439. doi:10.1111/j.1532-5415.1990.tb03542.x
  • 20. Jirovec MM, Wells TJ. Urinary incontinence in nursing home residents with dementia: The mobility-cognition paradigm. Applied Nursing Research. 1990;3(3):112-117. doi:10.1016/S0897-1897(05)80126-0
  • 21. Jewett MAS, Fernıe GR, Hollıday PJ, Pım ME. Urinary Dysfunction in a Geriatric Long‐Term Care Population: Prevalence and Patterns. J Am Geriatr Soc. 1981;29(5):211-214. doi:10.1111/j.1532-5415.1981.tb01768.x
  • 22. McLaren SM. Prevalence and severity of incontinence among hospitalised female female psychogeriatric patients." Health Bull 39 (1981): 157-161.https://pubmed.ncbi.nlm.nih.gov/term=Prevalence+and+severity+of+incontinence+among+hospitalised%2C+&filter=datesearch.y_5
  • 23. Borrie MJ, Davidson HA. Incontinence in institutions: Costs and contributing factors. CMAJ. 1992;147(3):322-328.
  • 24. Schnelle JF, MacRae PG, Ouslander JG, Simmons SF, Nitta M. Functional Incidental Training, Mobility Performance, and Incontinence Care with Nursing Home Residents. J Am Geriatr Soc. 1995;43(12):1356-1362. doi:10.1111/j.1532-5415.1995.tb06614.x
  • 25. Waite SJ, Maitland S, Thomas A, Yarnall AJ. Sarcopenia and frailty in individuals with dementia: A systematic review. Archives of Gerontology and Geriatrics. 2021;92. doi:10.1016/j.archger.2020.104268
  • 26. Moon Y, Moon WJ, Kim JO, Kwon KJ, Han SH. Muscle Strength Is Independently Related to Brain Atrophy in Patients with Alzheimer’s Disease. Dementia and Geriatric Cognitive Disorders. 2019;474-6):306-314. doi:10.1159/000500718
  • 27. Burns JM, Johnson DK, Watts A, Swerdlow RH, Brooks WM. Reduced lean mass in early Alzheimer disease and its association with brain atrophy. Arch Neurol. 2010;67(4):428-433. doi:10.1001/ARCHNEUROL.2010.38
  • 28. Chong MS, Tay L, Ismail NH, et al. The Case for Stage-Specific Frailty Interventions Spanning Community Aging to Cognitive Impairment. J Am Med Dir Assoc. 2015;16(11):1003.e13-1003.e19. doi:10.1016/J.JAMDA.2015.08.025
  • 29. Silva RRL, Coutinho JFV, Vasconcelos CTM, et al. Prevalence of sarcopenia in older women with pelvic floor dysfunction. Eur J Obstet Gynecol Reprod Biol. 2021;263:159-163. doi:10.1016/J.EJOGRB.2021.06.037
  • 30. Mutlay F, ERKEN N, Günay FSD, Kaya D, Isik AT. Yaşlılarda Depresyon Düşme Sıklığı ile İlişkilendirilebilir mi? Geriatrik Bilimler Dergisi. 2020; 3(3):103-109 doi:10.47141/geriatrik.826378
  • 31. Heijnen WTCJ, Kamperman AM, Tjokrodipo LD, Hoogendijk WJG, van den Broek WW, Birkenhager TK. Influence of age on ECT efficacy in depression and the mediating role of psychomotor retardation and psychotic features. Journal of Psychiatric Research. 2019;109:41-47. doi:10.1016/J.JPSYCHIRES.2018.11.014
  • 32. von Coelln R, Dawe RJ, Leurgans SE, et al. Quantitative mobility metrics from a wearable sensor predict incident parkinsonism in older adults. Parkinsonism & Related Disorders. 2019;65:190-196. doi:10.1016/J.PARKRELDIS.2019.06.012
  • 33. Stanaway FF, Gnjidic D, Blyth FM, et al. How fast does the Grim Reaper walk? Receiver operating characteristics curve analysis in healthy men aged 70 and over. BMJ. 2011;343:d7679. doi:10.1136/bmj.d7679
There are 33 citations in total.

Details

Primary Language Turkish
Subjects Clinical Sciences
Journal Section Articles
Authors

Fatma Sena Dost 0000-0002-3748-8156

Açelya Gökdeniz Yıldırım 0000-0003-2932-3797

Esra Ateş Bulut 0000-0002-1124-9720

Ali Ekrem Aydın 0000-0003-0182-2850

Ahmet Turan Işık 0000-0001-5867-6503

Early Pub Date August 18, 2022
Publication Date August 31, 2022
Acceptance Date June 13, 2022
Published in Issue Year 2022 Volume: 5 Issue: 2

Cite

APA Dost, F. S., Gökdeniz Yıldırım, A., Ateş Bulut, E., Aydın, A. E., et al. (2022). Demans Hastalarında Üriner İnkontinans ve Sarkopeni İlişkisi. Journal of Cukurova Anesthesia and Surgical Sciences, 5(2), 107-115. https://doi.org/10.36516/jocass.1117649

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