Frailty, cognitive impairment, and functional disability in older women with female pelvic floor dysfunction
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Introduction and hypothesis
There is a growing body of evidence demonstrating frailty as an important predictor of surgical outcomes in older adults undergoing major surgeries. The age-related onset of many symptoms of female pelvic floor dysfunction (PFD) in women suggests that many women seeking treatment for PFD may also have a high prevalence of frailty, which could potentially impact the risks and benefits of surgical treatment options. Our primary objective was to determine the prevalence of frailty, cognitive impairment, and functional disability in older women seeking treatment for PFD.
We conducted a cross-sectional study with prospective recruitment between September 2011 and September 2012. Women, age 65 years and older, were recruited at the conclusion of their new patient consultation for PFD at a tertiary center. A comprehensive geriatric screening including frailty measurements (Fried Frailty Index), cognitive screening (Saint Louis University Mental Status score), and functional status evaluation for activities of daily living (Katz ADL score) was conducted.
Sixteen percent (n/N = 25/150) of women were categorized as frail according to the Fried Frailty Index score. After adjusting for education level, 21.3 % of women (n/N = 32/150) screened positive for dementia and 46 (30.7 %) reported functional difficulty or dependence in performing at least one Katz ADL. Sixty-nine women (46.0 %) chose surgical options for treatment of their PFD at the conclusion of their new patient visit with their physician.
Frailty, cognitive impairment, and functional disability are common in older women seeking treatment for PFD.
KeywordsFemale pelvic floor dysfunction Frailty Functional disability Pelvic organ prolapse Urinary incontinence
This research was supported in part by a grant from the American Urogynecologic Society (AUGS) Foundation. Dr. Erekson was supported through a grant from the Claude D. Pepper Older Americans Independence Center at Yale University School of Medicine (#P30AG021342 NIH/NIA). The funding agreement ensured the authors independence in designing the study, interpreting the data, and writing and publishing the article.
Conflicts of interest
- 2.Dasgupta M, Rolfson DB, Stolee P, Borrie MJ, Speechley M (2009) Frailty is associated with postoperative complications in older adults with medical problems. Arch Gerontol Geriatr 48(1):78–83Google Scholar
- 12.Yip SO, Dick MA, McPencow AM, Martin DK, Ciarleglio MM, Erekson EA (2013) The association between urinary and fecal incontinence and social isolation in older women. Am J Obstet Gynecol 208(2):146.e1–146.e7Google Scholar
- 15.Tariq SH, Tumosa N, Chibnall JT, Perry MH 3rd, Morley JE (2006) Comparison of the Saint Louis University mental status examination and the mini-mental state examination for detecting dementia and mild neurocognitive disorder—a pilot study. Am J Geriatr Psychiatry 14(11):900–910CrossRefPubMedGoogle Scholar
- 20.Irwin M, Artin KH, Oxman MN (1999) Screening for depression in the older adult: criterion validity of the 10-item Center for Epidemiological Studies Depression Scale (CES-D). Arch Intern Med 159(15):1701–1704Google Scholar
- 27.Robinson TN, Finlayson E (2014) How to best forecast adverse outcomes following geriatric trauma: an ageless question? JAMA Surg 149(8):773Google Scholar