TAthe GRAPPPA* (Clinical research Group of perineal dysfunctions in older adults)
the GRAPPPA* (Clinical research Group of perineal dysfunctions in older adults)
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The main goal of this retrospective study is to explore the predictors of success in learning clean intermittent self-catheterization (CISC) in patients over 65 years of age. The secondary goal is to assess whether in this population, the risk of failure to perform CISC is greater, compared with patients under 65 with similar pathologies. All patients older than 65 consulting between January 2011 and January 2016 for learning CISC were included. A control population younger than 65 matching with sex, body mass index, and pathology was selected. One hundred sixty-nine of the 202 patients (83.7%) over 65 succeeded in learning CISC. Obesity (P<0.05), low pencil and paper test (PP test) (P<0.01) and low functional independence measure (FIM) (P<0.01) scores were risk factors of failure. No significant differences were found with sex or pathology. In multivariate analysis, low PP test perineum access (odds ratio [95% confidence interval], 2.30 [1.32-4.42]), low FIM motor (1.04 [1.01-1.08]), and FIM cognition (1.18 [1.03-1.37]) scores were independent factors of learning failure. Compared to control group, age over 65 was not predictive of failure (P=0.15). Our study shows that success in learning CISC does not depend on age but on difficulties in mobility, access to perineum and probably cognitive disorders.
Background: The objective of this study is to evaluate current literature on the association between cognitive dysfunction and nocturia. Methods: A systematic review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) statement was conducted through MEDLINE, EMBASE and COCHRANE databases and completed in November 2019. Randomized and non-randomized studies were included if they assessed the association between cognitive dysfunction and nocturia in older participants with or without neurological diseases. The quality of included studies was evaluated using the Risk of Bias Assessment tool for Non-randomized Studies (RoBANS). Results: A total of 8 cross-sectional studies conducted in older patient populations met the criteria for inclusion. A statistically significant association was identified in 6 studies on univariate analysis, which persisted in 2 studies after controlling for confounding factors. The association between cognitive dysfunction and nocturia was positive for all 6 significant analyses. The overall risk of bias was unclear. Conclusion: A significant positive association between cognitive dysfunction and nocturia was identified. However, research has been limited to cross-sectional studies, which precludes identification of causality between cognitive dysfunction and nocturia. Heightened awareness of the complex interplay between cognition and nocturia would allow professionals involved in the care of cognitively impaired patients with concomitant nocturia to more effectively manage these symptoms.
1 March 2022 in Annals of Physical and Rehabilitation Medicine