Demans Hastalarında Üriner İnkontinans ve Sarkopeni İlişkisi

Year 2022, Volume: 5 Issue: 2, 107 - 115, 31.08.2022

Fatma Sena Dost , Açelya Gökdeniz Yıldırım , Esra Ateş Bulut , Ali Ekrem Aydın , Ahmet Turan Işık

https://doi.org/10.36516/jocass.1117649

Abstract

Amaç: Demans, sarkopeni ve üriner inkontinans (Üİ) sık görülen geriatrik sendromlardır. Üİ, yaşam kalitesini etkileyen, sosyal izolasyon ile sonuçlanan, düşmeye ve düşmeye bağlı morbidite ve mortaliteye de sebep olan bir durumdur. Ayrıca demans hastalarında bakım yükünü ve bakım veren tükenmişliğini artırır. Kontinans için sağlam bir genito-üriner sistem, periferik ve santral sinir sistemi ve de biliş gerekmektedir. Bunun yanında çizgili kas grubundan pelvik taban kaslarının ve iskelet sisteminin de kontinanstaki önemi göz ardı edilemez. Çalışmamızda demans hastalarında Üİ ile sarkopeni arasındaki ilişkiyi değerlendirmeyi planladık.
Materyal ve Metot: Ocak 2015 ve Aralık 2021 tarihleri arasında Dokuz Eylül Üniversitesi Geriatri birimine başvuran sarkopeni değerlendirmesi olan demans hastaları çalışmaya dahil edilmiştir. Hastalar Üİ durumlarına göre iki gruba ayrılmıştır. Sarkopeni tanısı EWGSOP-2 kriterleri kullanılarak konulmuştur.
Bulgular: Gruplar arasında demografik veriler ve laboratuvar bulgularında anlamlı farklılık saptanmadı. Depresyon ve anti-parkinson ilaç kullanımı Üİ grubunda daha sıktı. Üİ grubunda muhtemel sarkopeni, ciddi sarkopeni, düşük yürüme hızı ve kırılganlık sıklığı daha yüksek; temel günlük yaşam aktivite skoru daha düşük bulundu (p <0,050). Regresyon analizi yapıldığında Üİ; muhtemel sarkopeni, ciddi sarkopeni ve düşük yürüme hızı ile ilişkili bulundu (OR:1,854, %95 CI 1,107-3,106; OR:2,152, %95 CI 1,193-7,360; Or:3,065, %95 CI 1,726 –5,443).
Sonuç: Demansın küratif tedavisinin olmaması nedeniyle eşlik eden komorbid durumların tedavisi ve önlenmesi büyük önem kazanmaktadır. Yaşam kalitesinin artması ve bakım yükünün azaltılmasında Üİ ile mücadele önemlidir. Sarkopeni ve Üİ ilişkisinin akılda tutulması ve buna yönelik girişimler faydalı olabilir.
Anahtar kelimeler: Demans, sarkopeni, üriner inkontinans.

Keywords

Demans, sarkopeni, üriner inkontinans

Supporting Institution

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The Relationship Between Urinary Incontinence and Sarcopenia in Patients with Dementia

Abstract

Aim: Dementia, sarcopenia, and urinary incontinence (UI) are common geriatric syndromes. UI is a condition that affects the quality of life, results in social isolation, causes falls and, causes morbidity and mortality due to falls. UI also increases caregiver burnout and the burden of care in dementia patients. Continence requires an intact genito-urinary system, peripheral and central nervous system, and cognitive health. In addition, the importance of the pelvic floor muscles from the striated muscle group and the skeletal system in continence cannot be ignored. In the light of these facts, we aimed to evaluate the relationship between UI and sarcopenia in patients with dementia.
Materials and Method: Dementia patients with sarcopenia who applied to the DEU Geriatrics unit between January 2015 and December 2021 were included. Patients with CDR 3 dementia and those with acute problems were excluded. Patients were grouped according to their UI status and evaluated for sarcopenia using the EWGSOP-2 criteria.
Results: According to the presence of UI, no significant difference was found in demographic and laboratory findings between groups. The frequency of anti-parkinsonian drug usage and depression was more common in the UI group. While, the frequency of probable sarcopenia, severe sarcopenia, slow gait speed, and frailty was higher in the UI group; Barthel's score was lower (p <0.050, for each). After regresion analysis, UI was associated with probable sarcopenia, severe sarcopenia, and slow gait speed (OR: 1.854, 95% CI 1.107-3.106; OR: 2.152, 95% CI 1.193-7.360; OR: 3.065, 95% CI 1.726 –5.443, respectively).
Conclusion: Due to the lack of proven treatment for dementia itself, the treatment and prevention of comorbidities have great importance. Treatment of UI is important in increasing the quality of life and reducing the burden of care. The relationship between sarcopenia and UI should be kept in mind. Moreover, interventions for sarcopenia may be beneficial for UI.

Keywords

Dementia, sarcopenia, urinary incontinence

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