长沙市养老机构老年人尿失禁的流行现况及影响因素

目的  研究长沙市养老机构老年人尿失禁(urinary incontinence, UI)的患病率及其影响因素。方法  2018年6月1日-2018年12月31日，采用整群抽样对长沙市6区2县床位数≥200张的养老院中所有符合条件的老年人进行问卷调查。结果  养老机构老年人UI患病率24.01%，中、重度UI为主，占66.24%。冠心病(OR=2.13, 95% CI: 1.37~3.31, P=0.001)、既往手术史(OR=1.68, 95% CI: 1.14~2.50, P=0.010)、活动能力[不能活动(OR=7.32, 95% CI: 3.22~16.69, P < 0.001)、借助轮椅行走(OR=4.76, 95% CI: 2.37~9.56, P < 0.001)、他人帮助行走(OR=1.90, 95% CI: 1.03~3.52, P=0.040)]和便秘(OR=1.96, 95% CI: 1.30~2.95, P=0.001)是UI的独立危险因素。步行能力受损[借助轮椅(OR=6.09, 95% CI: 2.11~17.55, P=0.001)、他人帮助(OR=4.34, 95% CI: 1.46~12.92, P=0.008)]和焦虑抑郁(OR=2.22, 95% CI: 1.09~4.51, P=0.029)会加重UI程度。结论  治疗老年人便秘和冠心病，保持身体活动功能和心理健康，对预防和治疗老年人UI可能具有重要意义。

Urinary incontinence prevalence and determinants among old population in nursing homes in Changsha City

  Objective  To study the prevalence of urinary incontinence(UI) and its determinants among old population in nursing homes in Changsha City.  Method  A cluster sampling was used to conduct a questionnaire survey on all eligible paticipants who lived in nursing homes with ≥200 beds in six Districts and two Counties of Changsha City from June 1 to December 31, 2018.  Results  The UI prevalence was 24.01%, among them, the moderate and severe UI accounted for 66.24%. Cardiovascular disease (OR=2.13, 95% CI: 1.37-3.31, P=0.001), surgical history (OR=1.68, 95% CI: 1.14-2.50, P=0.010), reduced mobility [immobility (OR=7.32, 95% CI: 3.22-16.69, P < 0.001), wheelchair dependent walking (OR=4.76, 95% CI: 2.37-9.56, P < 0.001), assistance dependent walking (OR=1.90, 95% CI: 1.03-3.52, P=0.040)] and constipation (OR=1.96, 95% CI: 1.30-2.95, P=0.001) were significant risk factors for UI. Impaired walking ability [wheelchair dependent walking (OR=6.09, 95% CI: 2.11-17.55, P=0.001), assistance dependent walking (OR=4.34, 95% CI: 1.46-12.92, P=0.008)], and anxiety or depression (OR=2.22, 95% CI: 1.09-4.51, P=0.029) increased UI severity.  Conclusion  It's of great significant to treat constipation and cardiovascular disease, and keep mobility function and mental health in older population, which may prevent or remedy UI.