Citation
Lee, C.Y, Chen, L.K, Lo, Y.K, Liang, C.K, Chou, M.Y, Lo, C.C, Huang. C.T, Lin, Y.T. (2011) Urinary incontinence: an under-recognized risk factor for falls among elderly dementia patients. Neurourol Urodyn. Sep;30(7):1286-90.
Article Summary
“Urinary incontinence: an under-recognized risk factor for falls among elderly dementia patients” is a research article by Lee et al, which addresses the issue of urinary incontinence among the elderly, and its cormobid risk factor of falls among elderly dementia patients (Lee et al, 2011). According to the article, urinary incontinence is a very common condition among the elderly patients and it is often characterized with unintentional or instinctive leakage of urine that increase the risk falls. The main objective of this study was purposely to determine the role of urinary incontinence as an under recognized risk factor for falls among elderly dementia patients.
In terms of methodology, this research study adopted the use of descriptive cross-sectional study to evaluate the risk factors for falls among elderly dementia patients using a Comprehensive Geriatric Assessment (CGA) tool (Polit & Beck, 2012). The research participants were recruited based on the inclusion and exclusion criteria concepts, where only elderly patients with dementia were recruited. All subjects first underwent a Comprehensive Geriatric Assessment (CGA), from where the participants were divided into two groups (experimental and control groups) of fall and non-fall patients based on their past medical history (history of falls) (Lee et al, 2011). Differences in variable and participants findings were analyzed via multivariate analysis, where all statistical operations adopted the use of Stata SE software version 9.0. Correlation between the variables and test groups was established via the use of t-tests and chi-squared tests, with the determination of independent risk factor for falls adopting the use logistic regression analysis (Katapodi & Northouse, 2011).
Of the total 159 participants, 54 patients or 34.0% had experienced falls in the past one year, and a total of 12.0% exhibited severe dementia, 50.3% exhibited mild dementia, and 37.7% exhibited moderate dementia based on the data collection tool (Clinical Dementia Rating scale). Participants in the experimental group also showed poorer balance and physical function, and had increased levels of urinary incontinence establishing urinary incontinence as the only independent risk factor for falls (Lee et al, 2011).
The researchers formulated their conclusion based on the research methodology used and result findings obtained. The conclusion was established to confirm the research objectives and hypothesis, which is this case was to establish and confirm whether urinary incontinence is a risk factor for falls among elderly dementia patients (Polit & Beck, 2012). Based on the methodology and analysis used, this study had several limitations, one being that the study was conducted in a memory clinic of a tertiary medical center meaning that the caregivers could have been more educated on the basic knowledge of preventing falls (a concept that explains reduced fall rate in the facility). Secondly, more than half of the research study participants were receiving anti-dementia medications and this could have improved their gait hence leading to reduced risk of falls (Katapodi & Northouse, 2011). The research also adopted the use of a sample test, and its results could not be generalized and it was impossible to correlate or build strong relationships between the variable sand the outcomes. Based on these limitations, though urinary incontinence was identified as a risk factor for falls among elderly dementia patients ,the result findings were not a true reflection of the picture on the ground because the facility were the research was conducted had adopted strategies to reduce falls among its patients (Lee et al, 2011). Therefore, one alternate interpretation for this data is that it was not conclusive enough to build concise relationship between urinary incontinence and risk factor for falls among elderly dementia patients. The study proposes or recommends further research in the field to establish and focus more on how urinary incontinence management can improve the effectiveness of fall prevention among these patients (Lee et al, 2011).
References
Katapodi, M. C., & Northouse, L. L. (2011). Comparative effectiveness research: Using systematic reviews and meta-analyses to synthesize empirical evidence. Research & Theory for Nursing Practice, 25(3), 191–209.
Lee, C.Y, Chen, L.K, Lo, Y.K, Liang, C.K, Chou, M.Y, Lo, C.C, Huang. C.T, Lin, Y.T. (2011) Urinary incontinence: an under-recognized risk factor for falls among elderly dementia patients. Neurourol Urodyn. Sep;30(7):1286-90.
Polit, D. F., & Beck, C. T. (2012). Nursing research: Generating and assessing evidence for nursing practice (Laureate Education, Inc., custom ed.). Philadelphia, PA: Lippincott Williams & Wilkins.
