Incontinence in Older Adults Going Beyond the Bladder老年人超越膀胱失禁.pptVIP

Take Homes Continence depends on more than the lower urinary tract Office based history and physical Use behavioral treatment first Drugs for urge incontinence differ more in tolerability than efficacy * Urinary incontinence is a widespread problem and an estimated 13 million American men and women suffer from it. The condition affects 15% to 35% of the elderly population living at home, and is present in more than half of the 1.5 million nursing home residents in the United States.1 Even though 50% of nursing home residents suffer from the condition, only a small percentage are being actively treated. Urinary incontinence increases the risk of hospitalization and admission to long-term care facilities2 and has been associated with loss of independence and other deleterious effects on quality of life.3 It affects the physical and emotional well-being of millions of American men and women.1 The total cost of urinary incontinence was estimated at $26 billion in 1995, and $3600 annually per person older than 65 years.4 We need to make sure that we are not missing the opportunity to treat this condition merely because some people think it is a “normal” consequence of aging or because of concerns about cost of therapy. 1. Clinical Practice Guidelines: Urinary Incontinence in Adults: Acute and Chronic Management. Rockville, Md: US Dept of Health and Human Services, Agency for Health Care Policy and Research; 1996:5. AHCPR publication 96-0682. 2. Thom DH, Haan MN, Van Den Eeden SK. Medically recognized urinary incontinence and risks of hospitalization, nursing home admission, and mortality. Age Ageing. 1997;26:367-374. 3. Lenderking WR, Nackley JF, Anderson RB, Testa MA. A review of the quality-of-life aspects of urinary urge incontinence. Pharmacoeconomics. 1996;9:11-23. 4. Wagner TH, Hu T-W. Economic costs of urinary incontinence in 1995. Urology.  1998;51:355-361. Incontinence in Older Adults:Going Beyond the Bladder Catherine E. DuBeau, MD Clinical Chief