ABSTRACT
Objective: Urinary incontinence
(UI) impacts all aspects of life activities. This study aims to characterize change
in mobility within the community utilizing the Life Space Assessment (LSA) questionnaire
in women undergoing non-surgical UI treatment. Methods: This prospective cohort
study, performed from July 2007 to March 2009, followed women seeking non-surgical
UI treatment from an outpatient tertiary-care clinic and assessed their mobility
and symptoms using LSA, Urogenital Distress Inventory (UDI-6), and Incontinence
Impact Questionnaire (IIQ-7) at baseline and 2, 6, and 12 months post-treatment.
Estimated Percent Improvement (EPI) and Patient Satisfaction Question (PSQ) were
obtained post-treatment. The women were treated with multi-component behavioral
and/or pharmacologic therapies, and we hypothesized that LSA would improve with
treatment. Repeated measures analysis with Tukey’s HSD and backwards selection linear
regression model were performed. Results: 70 ambulatory, community-dwelling women,
aged 65 years or older, seeking non-surgical care for UI were recruited. LSA score
decreased from baseline to 2 months (mean ± SD; 63 ± 29 to 56 ± 28, p < 0.001)
and was sustained at 6 and 12 months (54 ± 28, 54 ± 28). UDI scores improved from
36 ± 23 to 25 ± 24, p < 0.001, at 2 months, and improvement persisted at 6 and
12 months (22 ± 22, 21 ± 24). Improvements in UDI and patient perceived improvement
in UI were not associated with LSA change. Age, race, and depression impacted LSA,
which decreased 1-point for each additional year of age (p = 0.004), 6-points for
each point higher on the Geriatric Depression Scale (GDS) (p = 0.002), and 6-point
for African American race (p = 0.048). Conclusion: Decreased mobility represented
by LSA was related to age, depression, and race, but not UI symptom improvement.