Life Space Assessment in Older Women Undergoing Non-Surgical Treatment for Urinary Incontinence

Thomas L. Wheeler II^1*, Jana D. Illston¹, Alayne D. Markland², Patricia S. Goode², Holly E. Richter³

¹Department of Obstetrics and Gynecology, University of South Carolina School of Medicine-Greenville, Greenville, USA.
²Division of Gerontology, Geriatrics and Palliative Care, University of Alabama at Birmingham, Birmingham, USA.
³Department of Obstetrics and Gynecology, University of Alabama at Birmingham, Birmingham, USA.

DOI: 10.4236/ojog.2014.414112                

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.

Keywords

Urinary Incontinence, Life-Space, Depression, Mobility, Community-Dwelling Women

Conflicts of Interest

The authors declare no conflicts of interest.

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