1
|
Xiang SY, He HC, Liu Y, Yu BJ, Mai SY, Li MY, Yan XY, Huang XH. Care Needs of Older Adults With Urinary Incontinence: A Cross-Sectional Study. J Gerontol Nurs 2024; 50:43-49. [PMID: 38691116 DOI: 10.3928/00989134-20240416-07] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/03/2024]
Abstract
PURPOSE To explore care requirements of older adults with urinary incontinence (UI) and contributing factors. METHOD This cross-sectional study used the Older Adults Urinary Incontinence Care Needs Inventory to survey participants with UI in three large-scale tertiary hospitals located in Guangzhou City, China, from January 2023 to November 2023. Statistical analyses, including analysis of variance, t tests, correlation analyses, and linear regression models, were conducted to assess factors influencing participants' care needs. RESULTS A total of 530 older adults with UI participated in the survey and mean standardized score for overall care needs was 78.65 (SD = 5.01), with mean scores for each dimension ranging from 70.88 (SD = 10.55) for social participation needs to 82.45 (SD = 7.11) for health education needs. Factors that were found to influence incontinence care needs in older adults included age, literacy level, number of leaks, and type of disease (F = 37.07, adjusted R2 = 0.290, p < 0.001). CONCLUSION Comprehensive care for older adults with UI, encompassing physiological, psychological, and social aspects, is crucial. It is essential to tailor care to individual needs and characteristics, taking into account factors, such as age and education, to ensure effective care. [Journal of Gerontological Nursing, 50(5), 43-49.].
Collapse
|
2
|
Di J, Nelson RS, Jicha GA, Moga DC, Barber JM, Cykowski MD, Fardo DW, Abner EL, Nelson PT. Urinary Incontinence in a Community-Based Autopsy Cohort Is Associated with Limbic Predominant Age-Related TDP-43 Encephalopathy Neuropathologic Changes. J Alzheimers Dis 2023; 94:333-346. [PMID: 37248909 PMCID: PMC10618953 DOI: 10.3233/jad-230425] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
BACKGROUND Dementia and urinary incontinence (UI) are etiologically complex clinical syndromes. Dementia and UI often occur in the same individuals, but underlying factors connecting them are incompletely understood. OBJECTIVE Query data from a community-based autopsy series to assess pathologies that underlie UI. METHODS Included research subjects came to autopsy from the University of Kentucky Alzheimer's Disease Research Center longitudinal cohort. A total of 368 research volunteers met inclusion criteria for this cross-sectional study. The average age at death was 85.3 years and the average number of annual clinic visits was 5.2 visits. Statistical models were run to evaluate which pathologies were associated with UI. Data included pathologies scored according to conventional stage-based systems, and these studies were complemented by quantitative digital neuropathology. RESULTS Dementia was diagnosed at the final clinical visit in 208 (56.7% of the sample) and UI was documented in 156 (42.7%). UI was associated with depression and dementia (both p < 0.001). More women than men had a history of UI (p < 0.04), and women with UI had had more biological children than those without UI (p < 0.005). Participants with limbic predominant age-related TDP-43 encephalopathy neuropathologic changes (LATE-NC) were more likely to have UI than those without LATE-NC (p < 0.001). The presence of LATE-NC (Stage > 1) was associated with UI with or without severe Alzheimer's disease neuropathologic changes and/or Lewy body pathology. CONCLUSION In this community-based autopsy cohort, multiple factors were associated with UI, but the neuropathologic change most robustly associated with UI was LATE-NC.
Collapse
Affiliation(s)
- Jing Di
- University of Kentucky Department of Pathology and Laboratory Medicine, Lexington, KY
| | | | - Gregory A. Jicha
- Sanders-Brown Center on Aging Lexington, KY
- Department of Neurology, Lexington, KY
| | - Daniela C. Moga
- Sanders-Brown Center on Aging Lexington, KY
- Department of Pharmacology, Lexington, KY
| | | | | | - David W. Fardo
- Sanders-Brown Center on Aging Lexington, KY
- Department of Biostatistics, Lexington, KY
| | - Erin L. Abner
- Sanders-Brown Center on Aging Lexington, KY
- College of Public Health, Lexington, KY
| | - Peter T. Nelson
- University of Kentucky Department of Pathology and Laboratory Medicine, Lexington, KY
- Sanders-Brown Center on Aging Lexington, KY
| |
Collapse
|
3
|
Yan H, Chen H, Liu Y, Zhang Q, Guo Y, Fu Y, Ren H, Wang H, Wang C, Ge Y. Assessment of cognitive impairment after acute cerebral infarction with T1 relaxation time measured by MP2RAGE sequence and cerebral hemodynamic by transcranial Doppler. Front Neurol 2022; 13:1056423. [PMID: 36561306 PMCID: PMC9763460 DOI: 10.3389/fneur.2022.1056423] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 11/23/2022] [Indexed: 12/12/2022] Open
Abstract
Objective This study aimed to investigate early brain microstructural changes discovered using magnetization-prepared two rapid acquisition gradient echo (MP2RAGE) sequence and cerebral hemodynamic using TCD for cognitive impairment after acute cerebral infarction. Methods We enrolled 43 patients with acute cerebral infarction and 21 healthy people in the study, who were subjected to cognitive assessments, the MP2RAGE sequence, and a cerebral hemodynamic examination. A total of 26 brain regions of interest were investigated. Furthermore, we used cerebral hemodynamics to explain brain microstructural changes, which helped us better understand the pathophysiology of cognitive impairment after acute cerebral infarction and guide treatment. Results T1 relaxation times in the left frontal lobe, right frontal lobe, right temporal lobe, left precuneus, left thalamus, right hippocampus, right head of caudate nucleus, and splenium of corpus callosum were substantially different across the three groups, which were significantly correlated with neuropsychological test scores. CI group patients had significantly lower cerebral blood flow velocity than those in the N-CI and Normal groups. The receiver operating curve analysis revealed that most T1 relaxation times had high sensitivity and specificity, especially on the right temporal lobe and right frontal lobe. There was a potential correlation between T1 relaxation times and MMSE scores through TCD parameters. Conclusion The MP2RAGE sequence can detect alterations in whole brain microstructure in patients with cognitive impairment after acute cerebral infarction. Brain microstructural changes could influence cognitive function through cerebral hemodynamics. T1 relaxation times on the right temporal lobe and the right frontal lobe are expected to be a prospective biomarker of cognitive impairment after acute cerebral infarction.
Collapse
Affiliation(s)
- Hongting Yan
- The Department of Neurology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Honghai Chen
- The Department of Radiology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Yanzhi Liu
- The Department of Neurology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Qiannan Zhang
- The Department of Neurology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Yunchu Guo
- The Department of Neurology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Yu Fu
- The Department of Neurology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Hongling Ren
- The Department of Neurology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Hairong Wang
- The Department of Neurology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China
| | - Chun Wang
- The Department of Neurology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China,*Correspondence: Chun Wang
| | - Yusong Ge
- The Department of Neurology, The Second Hospital of Dalian Medical University, Dalian, Liaoning, China,Yusong Ge
| |
Collapse
|
4
|
|
5
|
Majima T, Matsukawa Y, Funahashi Y, Kato M, Sassa N, Gotoh M. Urodynamic evaluation before and after to RARP to identify pre and intraoperative factors affecting postoperative continence. Neurourol Urodyn 2021; 40:1147-1153. [PMID: 33846995 DOI: 10.1002/nau.24650] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2021] [Revised: 02/09/2021] [Accepted: 02/10/2021] [Indexed: 11/05/2022]
Abstract
AIMS To investigate factors contributing to pre and postoperative urethral function in male patients who underwent robot-assisted radical prostatectomy (RARP) using the urethral pressure profile (UPP). METHODS Study A A total of 313 patients who underwent RARP between April 2013 and March 2015 were prospectively investigated. UPP was performed preoperatively in all patients. Correlation and multiple regression analyses were performed to investigate predictive factors for low preoperative maximum urethral closure pressure (MUCP). Study B To validate the predictive factors for low preoperative MUCP obtained in Study A, 755 patients who underwent RARP between May 2010 and October 2017 were retrospectively examined. Relationships between the time to pad-free status and the following factors were investigated: number of predictive factors, nerve-sparing surgery, and vesicourethral anastomosis (VUA) methods (barbed vs. nonbarbed suture). RESULTS Study A A total of 187 patients were enrolled. Multivariate analysis revealed that older age, large prostate volume, low erectile function domain scores in International Index Erectile Function 15, and use of calcium channel blockers were significantly associated with low preoperative MUCP. Study B A total of 515 patients were included. Cox proportional hazard regression showed that the number of predictive factors and VUA method were significantly associated with the time to pad-free status. CONCLUSIONS Our study demonstrated that older age, larger prostate volume, poor erectile function, and calcium channel blocker use could be predictive markers for recovery from postprostatectomy urinary incontinence.
Collapse
Affiliation(s)
- Tsuyoshi Majima
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Urology, Aichi Medical University, Nagakute, Japan
| | - Yoshihisa Matsukawa
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Yasuhito Funahashi
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Masashi Kato
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Naoto Sassa
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,Department of Urology, Aichi Medical University, Nagakute, Japan
| | - Momokazu Gotoh
- Department of Urology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| |
Collapse
|
6
|
Haddad R, Monaghan TF, Joussain C, Phé V, Bower W, Roggeman S, Robain G, Everaert K. Nocturia in patients with cognitive dysfunction: a systematic review of the literature. BMC Geriatr 2020; 20:230. [PMID: 32631237 PMCID: PMC7336631 DOI: 10.1186/s12877-020-01622-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Accepted: 06/18/2020] [Indexed: 01/17/2023] Open
Abstract
Background The objective of this study is to evaluate current literature on the association between cognitive dysfunction and nocturia. Methods A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was conducted through MEDLINE, EMBASE and COCHRANE databases and completed in November 2019. Randomized and non-randomized studies were included if they assessed the association between cognitive dysfunction and nocturia in older participants with or without neurological diseases. The quality of included studies was evaluated using the Risk of Bias Assessment tool for Non-randomized Studies (RoBANS). Results A total of 8 cross-sectional studies conducted in older patient populations met the criteria for inclusion. A statistically significant association was identified in 6 studies on univariate analysis, which persisted in 2 studies after controlling for confounding factors. The association between cognitive dysfunction and nocturia was positive for all 6 significant analyses. The overall risk of bias was unclear. Conclusion A significant positive association between cognitive dysfunction and nocturia was identified. However, research has been limited to cross-sectional studies, which precludes identification of causality between cognitive dysfunction and nocturia. Heightened awareness of the complex interplay between cognition and nocturia would allow professionals involved in the care of cognitively impaired patients with concomitant nocturia to more effectively manage these symptoms.
Collapse
Affiliation(s)
- Rebecca Haddad
- Department of Urology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium. .,GRC 001 GREEN Neuro-Urology Research Group, Sorbonne Université Rothschild Academic Hospital AP-HP, F-75012, Paris, France.
| | - Thomas F Monaghan
- Department of Urology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium.,Department of Urology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Charles Joussain
- Medical School Paris Île-de-France Ouest Inserm U1179, Versailles Saint-Quentin University, Versailles, France.,Department of Physical Medicine and Rehabilitation, Raymond-Poincaré Academic Hospital AP-HP, Garches, France
| | - Véronique Phé
- Department of Urology, Sorbonne Université Pitié-Salpêtrière Academic Hospital AP-HP, Paris, France
| | - Wendy Bower
- Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia
| | - Saskia Roggeman
- Department of Urology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| | - Gilberte Robain
- GRC 001 GREEN Neuro-Urology Research Group, Sorbonne Université Rothschild Academic Hospital AP-HP, F-75012, Paris, France
| | - Karel Everaert
- Department of Urology, Ghent University Hospital, Corneel Heymanslaan 10, 9000, Ghent, Belgium
| |
Collapse
|
7
|
Sugimoto T, Ono R, Kimura A, Saji N, Niida S, Sakai T, Rakugi H, Toba K, Sakurai T. Impact of Cognitive Frailty on Activities of Daily Living, Cognitive Function, and Conversion to Dementia Among Memory Clinic Patients with Mild Cognitive Impairment. J Alzheimers Dis 2020; 76:895-903. [PMID: 32568192 DOI: 10.3233/jad-191135] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Very few studies have investigated the impact of cognitive frailty in clinical settings, especially in memory clinic populations. OBJECTIVE To examine the impact of cognitive frailty on activities of daily living (ADL), cognitive function, and conversion to dementia among memory clinic patients with mild cognitive impairment (MCI). METHODS The subjects of this retrospective study were 248 MCI patients (mean age, 76.3±5.4 years; females, 60.9%). All subjects completed a comprehensive geriatric assessment at baseline and at least one assessment during 3-year follow-up. Frailty was defined by generating a frailty index (FI), and MCI patients with frailty (FI≥0.25) were considered to represent cognitive frailty. As primary outcomes, the Barthel Index, Mini-Mental State Examination, and incident dementia were evaluated during follow-up. At baseline, patients were assessed for apolipoprotein E (APOE) phenotype. A linear mixed model, as well as a Cox proportional hazards regression model with adjustment for confounding variables, was performed. RESULTS Of these patients, 75 (30.2%) were classified as cognitive frail. APOEɛ4 carriers accounted for 26.7% of those with cognitive frailty and 44.5% of those without (p = 0.008). Cognitive frail patients showed a faster ADL decline (estimate, -1.04; standard error, 0.38; p = 0.007) than patients without cognitive frailty. Cognitive frailty was not associated with cognitive decline and incident dementia. CONCLUSION Our findings demonstrated cognitive frailty increases the risk of dependence but not cognitive outcomes. Cognitive frailty may have heterogeneous conditions, including APOEɛ4-related pathologies, which may affect the cognitive trajectories of patients with MCI.
Collapse
Affiliation(s)
- Taiki Sugimoto
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.,Medical Genome Center, National Center for Geriatrics and Gerontology, Obu, Japan.,Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Rei Ono
- Department of Public Health, Kobe University Graduate School of Health Sciences, Kobe, Japan
| | - Ai Kimura
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.,Medical Genome Center, National Center for Geriatrics and Gerontology, Obu, Japan.,Department of Cognition and Behavior Science, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Naoki Saji
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Shumpei Niida
- Medical Genome Center, National Center for Geriatrics and Gerontology, Obu, Japan
| | | | - Hiromi Rakugi
- Department of Geriatric and General Medicine, Osaka University Graduate School of Medicine, Suita, Japan
| | - Kenji Toba
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan
| | - Takashi Sakurai
- Center for Comprehensive Care and Research on Memory Disorders, National Center for Geriatrics and Gerontology, Obu, Japan.,Department of Cognition and Behavior Science, Nagoya University Graduate School of Medicine, Nagoya, Japan
| |
Collapse
|
8
|
Kawaharada R, Sugimoto T, Matsuda N, Tsuboi Y, Sakurai T, Ono R. Impact of loss of independence in basic activities of daily living on caregiver burden in patients with Alzheimer's disease: A retrospective cohort study. Geriatr Gerontol Int 2019; 19:1243-1247. [DOI: 10.1111/ggi.13803] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2019] [Revised: 09/10/2019] [Accepted: 09/30/2019] [Indexed: 01/08/2023]
Affiliation(s)
- Rika Kawaharada
- Department of Public HealthKobe University Graduate School of Health Sciences Kobe Japan
| | - Taiki Sugimoto
- Department of Public HealthKobe University Graduate School of Health Sciences Kobe Japan
- Center for Comprehensive Care and Research on Memory DisordersNational Center for Geriatrics and Gerontology Obu Japan
- Medical Genome CenterNational Center for Geriatrics and Gerontology Obu Japan
| | - Naoka Matsuda
- Department of Public HealthKobe University Graduate School of Health Sciences Kobe Japan
| | - Yamato Tsuboi
- Department of Public HealthKobe University Graduate School of Health Sciences Kobe Japan
- Japan Society for the Promotion of Science Tokyo Japan
| | - Takashi Sakurai
- Center for Comprehensive Care and Research on Memory DisordersNational Center for Geriatrics and Gerontology Obu Japan
- Department of Cognitive and Behavioral ScienceNagoya University Graduate School of Medicine Nagoya Japan
| | - Rei Ono
- Department of Public HealthKobe University Graduate School of Health Sciences Kobe Japan
| |
Collapse
|
9
|
Dastgerdi AH, Radahmadi M, Pourshanazari AA, Dastgerdi HH. Effects of Crocin on Learning and Memory in Rats Under Chronic Restraint Stress with Special Focus on the Hippocampal and Frontal Cortex Corticosterone Levels. Adv Biomed Res 2017; 6:157. [PMID: 29387668 PMCID: PMC5767797 DOI: 10.4103/abr.abr_107_17] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Background: Chronic stress adversely influences brain functions while crocin, as an effective component of saffron, exhibits positive effects on memory processes. This study investigated the effects of different doses of crocin on the improvement of learning and memory as well as corticosterone (CORT) levels in the hippocampus and frontal cortex of rats subjected to chronic stress. Materials and Methods: Forty male rats were randomly allocated to five different groups (n = 8): Control, sham; stress (6 h/day for 21 days) groups, and two groups receiving daily intraperitoneal injections of one of two doses (30 and 60 mg/kg) of crocin accompanied by 21 days of restraint stress. Latency was evaluated as a brain function using the passive avoidance test before and one-day after a foot shock. CORT levels were measured in the homogenized hippocampus and frontal cortex. Results: Results revealed that chronic stress had a significantly (P < 0.01) negative effect on memory. Crocin (30 and 60 mg/kg), however, gave increase to significantly (P < 0.01 and P < 0.05; respectively) improved memory functions in the stressed rats. Furthermore, the CORT levels in the hippocampus and frontal cortex declined significantly (P < 0.05) in the stress group compared to the control. Only a crocin dose of 30 mg/kg was observed modulate significantly (P < 0.05) the CORT levels in the hippocampus and frontal cortex in the stressed group. Conclusions: It was found that the lower crocin dose (30 mg/kg) had more beneficial effects than its higher (60 mg/kg) dose on learning and memory under chronic stress conditions. Moreover, it was speculated that different doses of crocin act on different neurotransmitters and biochemical factors in the brain.
Collapse
Affiliation(s)
| | - Maryam Radahmadi
- Department of Physiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Asghar Pourshanazari
- Department of Physiology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | | |
Collapse
|