Frailty, Frailty Syndrome, Geriatric Syndrome, Geriatric Syndromes, Urinary Incontinence, Urinary Incontinence in Geriatric Population, Urinary Incontinence in Old Age, Urinary Incontinence (UI)
Conditions
Keywords
Urinary incontinence, Geriatric syndrome, Elderly individuals, Post-void residual urine volume, PVR, PHYSIOTHERAPY, Muscle strength, Physical parameters, Frailty, Sarcopenia, Physical performance, Falls
Brief summary
The aim of this cross-sectional observational study is to examine the independent associations of urinary incontinence severity and post-void residual urine volume with frailty and other geriatric outcomes in older adults presenting to a urology outpatient clinic with urinary incontinence.
Interventions
None listed
Sponsors
MERT UYSAL
Karabuk Training and Research Hospital
Karabuk University
Abant Izzet Baysal University
Study design
Observational model
CASE_ONLY
Time perspective
CROSS_SECTIONAL
Eligibility
Sex/Gender
ALL
Age
65 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Age 65 years or older, * Presence of involuntary urinary leakage according to the International Continence Society definition, * At least one urinary leakage episode during the previous four weeks and an ICIQ-UI SF score of ≥1, * General health status adequate to tolerate the outpatient assessment protocol, * Ability to mobilize independently, * Ability to understand instructions in Turkish and complete the study questionnaires, * Willingness to participate and provision of written informed consent.
Exclusion criteria
* Acute urinary tract infection or acute lower urinary tract symptoms, * History of major pelvic or orthopedic surgery within the previous six months, * Acute musculoskeletal condition that may affect performance during the assessments, * Neurological disease causing severe mobility limitations, including Parkinson's disease or stroke, * Diabetic neuropathy, * Severe cardiopulmonary disease, including New York Heart Association class III-IV heart failure or forced expiratory volume in one second below 30% of the predicted value, * Dementia or severe cognitive impairment, defined as Global Deterioration Scale stage 4 or higher, * Severe visual or hearing impairment that may prevent completion of the assessments, * Terminal illness or active malignancy, * Inability or unwillingness to provide informed consent, * Unwillingness or inability to complete the assessment protocol.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Frailty Level Assessed Using the FRAIL Scale | During the single study visit (cross-sectional baseline assessment) | The primary outcome is frailty level, assessed using the five-item FRAIL Scale. The total score ranges from 0 to 5, with higher scores indicating greater frailty. Participants will be classified as robust (0 points), prefrail (1-2 points), or frail (≥3 points). The primary exposures are urinary incontinence severity, assessed using the ICIQ-UI SF total score (range: 0-21), and post-void residual urine volume, recorded in milliliters as the mean of two consecutive bladder scanner measurements performed within 10 minutes after voiding. The independent associations of ICIQ-UI SF score and post-void residual urine volume with frailty level will be examined in the same multivariable regression model after adjustment for prespecified covariates. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Physical Performance Assessed Using the Short Physical Performance Battery | During the single study visit (baseline assessment) | Physical performance will be assessed using the Short Physical Performance Battery (SPPB), comprising standing balance, usual-paced walking, and five-repetition chair-rise tests. Each component is scored from 0 to 4, resulting in a total score ranging from 0 to 12. Higher scores indicate better physical performance. A total score of ≤8 will be considered indicative of low physical performance. |
| Functional Mobility Assessed Using the Timed Up and Go Test | During the single study visit (baseline assessment) | Functional mobility will be assessed using the Timed Up and Go Test (TUG). Participants will stand up from a chair, walk three meters, turn, walk back to the chair, and sit down. Completion time will be recorded in seconds, with longer times indicating poorer functional mobility. |
| Motor-Cognitive Mobility Assessed Using the Dual-Task Timed Up and Go Test | During the single study visit (baseline assessment) | Motor-cognitive mobility will be assessed using the Dual-Task Timed Up and Go Test (DT-TUG). Participants will complete the TUG while simultaneously performing serial subtraction by threes from 100. Completion time will be recorded in seconds, with longer times indicating poorer motor-cognitive mobility performance. |
| Handgrip Strength Measured Using a Hand Dynamometer | During the single study visit (baseline assessment) | Handgrip strength will be measured in the dominant hand using a BASELINE hand dynamometer. Three trials will be performed, and the highest value, recorded in kilograms, will be used in the analysis. Values below 27 kg in men and below 16 kg in women will be classified as low muscle strength. |
| Isometric Quadriceps Muscle Strength Measured Using a Hand-Held Dynamometer | During the single study visit (baseline assessment) | Isometric quadriceps muscle strength will be measured using a hand-held dynamometer (BASELINE) under a standardized testing protocol. Participants will perform two maximal voluntary isometric contractions with standardized verbal encouragement. The highest force value obtained from the two trials will be used in the analysis, with higher values indicating greater quadriceps muscle strength. |
| Concern About Falling Assessed Using the Falls Efficacy Scale-International | During the single study visit (baseline assessment) | Concern about falling will be assessed using the 16-item Falls Efficacy Scale-International (FES-I). Each item is scored from 1 to 4, producing a total score ranging from 16 to 64. Higher scores indicate greater concern about falling. Scores of 16-19, 20-27, and 28-64 will be classified as low, moderate, and high concern about falling, respectively. |
| Sleep Quality Assessed Using the Pittsburgh Sleep Quality Index | During the single study visit, reflecting sleep during the previous month. | Sleep quality will be assessed using the Pittsburgh Sleep Quality Index (PSQI), which evaluates subjective sleep quality, sleep latency, sleep duration, habitual sleep efficiency, sleep disturbances, use of sleep medication, and daytime dysfunction. The total score ranges from 0 to 21, with higher scores indicating poorer sleep quality. A total score greater than 5 will be considered indicative of poor sleep quality. |
Countries
Turkey (Türkiye)
Contacts
CONTACTMert Uysal, Lecturer
STUDY_CHAIREylem Tutun Yumin, Professor
Abant Izzet Baysal University
STUDY_DIRECTORMeral Sertel, Professor
Uludag University
STUDY_DIRECTORFahrettin Samil Uysal, Assistant Professor
Karabuk University
PRINCIPAL_INVESTIGATORMert Uysal, Lecturer
Karabuk University
Outcome results
None listed