Modeling Factors of Urinary Incontinence in Institutional Older Adults with Dementia.

Abstract

AIMS AND OBJECTIVES\nThis study applied structural equation modeling to explore the relationships among agitated behaviors, depression, cognitive function, and activities of daily living (ADL), as well as associations between these factors and urinary incontinence (UI).\n\n\nBACKGROUND\nA high prevalence of UI is found among institutional older adults with dementia. People with UI suffer from increased financial burden and social isolation and experience reduced quality of life.\n\n\nDESIGN\nCross-sectional, correlational research. The study complied with the Strengthening the Reporting of Observational Studies in Epidemiology (STROBE)\xa0Statement.\n\n\nMETHODS\nIn total, 226 older adults with dementia were recruited through convenience sampling at 15 long-term care facilities in southern Taiwan. The UI frequency, agitated behaviors, depression, cognitive function, and ADL were evaluated using bladder records, the Cohen-Mansfield Agitation Inventory (CMAI), the Cornell Scale for Depression in Dementia (CSDD), the Mini-Mental State Examination (MMSE), and the Barthel Index (BI), respectively.\n\n\nRESULTS\nADL performance was found to be significantly associated with UI; however, age, cognitive function, depression, and agitated behaviors were not significantly related to UI. Age did not have effects on any of the variables tested in this model, whereas ADL performance was significantly associated with cognitive function and depression. Results further showed that cognitive function and depression were mediators between ADL and agitated behaviors.\n\n\nCONCLUSION\nEnhanced ADL independency directly reduced UI, improved cognitive function, decreased degrees of depression, and indirectly reduced agitated behaviors.\n\n\nRELEVANCE TO CLINICAL PRACTICE\nThe findings could serve as a valuable reference for long-term care facilities in providing effective urinary incontinence care and prevention to older adults with dementia. This article is protected by copyright. All rights reserved.