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The relationship between sarcopenia and urinary incontinence

  • Tugba ErdoganEmail author
  • Gulistan Bahat
  • Cihan Kilic
  • Pınar Kucukdagli
  • Meryem Merve Oren
  • Onur Erdogan
  • Mehmet Akif Karan
Research Paper

Key summary points

Aim

The purpose of this research was to investigate the relationship between urinary incontinence (stress and/or urgency) and sarcopenia in a large group of female older adults.

Findings

UI is independently associated with sarcopenia when muscle mass was adjusted by weight and also with presence of low muscle mass when muscle mass was adjusted by weight or BMI.

Message

Evaluation of sarcopenia may have a role in the management of stress and urgency urinary incontinence.

Abstract

Purpose

Urinary incontinence (UI) is a common cause of morbidity in the female older adult. Identification of factors associated with UI is necessary to identify risky individuals, to take preventive measures, and to recognize commonly associated co-morbidities. We suggest that sarcopenia may be associated with UI through decrease in muscle mass/strength. In this study, we aimed to investigate the relationship between UI (stress and/or urgency) and sarcopenia.

Methods

Female older adults ≥ 60 years that applied to geriatric outpatient clinic were analyzed cross-sectionally. The presence of UI, UI types, fecal incontinence, and constipation was obtained. Functional status was assessed by basic and instrumental activities of daily living (ADL and IADL), nutrition by mini-nutritional assessment-short form (MNA-SF). Total muscle mass was measured by bioimpedance analysis. Hand grip strength and walking speed were assessed.

Results

A total of 802 female adults were included. The prevalence of UI was 48.9%. Associated factors with presence of UI were higher age and BMI, presence of fecal incontinence, constipation, lower activities of ADL and IADL scores, lower grip strength, lower skeletal muscle mass adjusted by weight and BMI, and presence of sarcopenia adjusted by weight and BMI. Independent factors related with UI were presence of fecal incontinence, constipation, IADL dependency, low muscle mass adjusted by weight and body mass index, and sarcopenia adjusted by weight.

Conclusion

The results of our study suggest that UI is independently associated with sarcopenia when muscle mass was adjusted by weight and also with presence of low muscle mass when muscle mass was adjusted by weight or BMI.

Keywords

Muscle mass Muscle strength Sarcopenia Urinary incontinence 

Notes

Funding

None.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of Istanbul University ethic committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.

Supplementary material

41999_2019_232_MOESM1_ESM.pdf (103 kb)
Supplementary material 1 (PDF 103 kb)

References

  1. 1.
    Abrams P, Andersson KE, Birder L et al (2010) Fourth International Consultation on Incontinence Recommendations of the International Scientific Committee: evaluation and treatment of urinary incontinence, pelvic organ prolapse, and fecal incontinence. Neurourol Urodyn 29:213–240CrossRefGoogle Scholar
  2. 2.
    Cruz-Jentoft AJ, Baeyens JP, Bauer JM et al (2010) Sarcopenia: European consensus on definition and diagnosis: report of the European Working Group on sarcopenia in older people. Age Ageing 39(4):412–423CrossRefGoogle Scholar
  3. 3.
    Muscaritoli M, Anker SD, Argilés J et al (2010) Consensus definition of sarcopenia, cachexia and pre-cachexia: joint document elaborated by Special Interest Groups (SIG) “cachexia-anorexia in chronic wasting diseases” and “nutrition in geriatrics”. Clin Nutr 29(2):154–159CrossRefGoogle Scholar
  4. 4.
    Fielding RA, Vellas B, Evans WJ et al (2011) Sarcopenia: an undiagnosed condition in older adults. Current consensus definition: prevalence, etiology, and consequences. International working group on sarcopenia. J Am Med Dir Assoc 12(4):249–256CrossRefGoogle Scholar
  5. 5.
    Morley JE, Abbatecola AM, Argiles JM et al (2011) Sarcopenia with limited mobility: an international consensus. J Am Med Dir Assoc 12(6):403–409CrossRefGoogle Scholar
  6. 6.
    Dam TT, Peters KW, Fragala M et al (2014) An evidence-based comparison of operational criteria for the presence of sarcopenia. J Gerontol A Biol Sci Med Sci 69(5):584–590CrossRefGoogle Scholar
  7. 7.
    Baumgartner RN, Koehler KM, Gallagher D et al (1998) Epidemiology of sarcopenia among the elderly in New Mexico. Am J Epidemiol 147(8):755–763CrossRefGoogle Scholar
  8. 8.
    Janssen I, Heymsfield SB, Ross R (2002) Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. J Am Geriatr Soc 50:889–896CrossRefGoogle Scholar
  9. 9.
    Cawthon PM, Peters KW, Shardell MD et al (2014) Cutpoints for low appendicular lean mass that identify older adults with clinically significant weakness. J Gerontol A Biol Sci Med Sci 69:567–575CrossRefGoogle Scholar
  10. 10.
    Oliveira M, Ferreira M, Azevedo MJ et al (2017) Pelvic floor muscle training protocol for stress urinary incontinence in women: a systematic review. Rev Assoc Med Bras (1992) 63(7):642–650CrossRefGoogle Scholar
  11. 11.
    Greer JA, Smith AL, Arya LA (2012) Pelvic floor muscle training for urgency urinary incontinence in women: a systematic review. Int Urogynecol J 23(6):687–697CrossRefGoogle Scholar
  12. 12.
    de Groat WC (1997) A neurologic basis for the overactive bladder. Urology 50(6A Suppl):36–52 (discussion 53–56) CrossRefGoogle Scholar
  13. 13.
    Arab AM, Chehrehrazi M (2011) The response of the abdominal muscles to pelvic floor muscle contraction in women with and without stress urinary incontinence using ultrasound imaging. Neurourol Urodyn 30(1):117–120CrossRefGoogle Scholar
  14. 14.
    Neumann P, Gill V (2002) Pelvic floor and abdominal muscle interaction: EMG activity and intra-abdominal pressure. Int Urogynecol J Pelvic Floor Dysfunct 13(2):125–132CrossRefGoogle Scholar
  15. 15.
    Sapsford RR, Hodges PW, Richardson CA et al (2001) Co-activation of the abdominal and pelvic floor muscles during voluntary exercises. Neurourol Urodyn 20(1):31–42CrossRefGoogle Scholar
  16. 16.
    Stav K, Alcalay M, Peleg S et al (2007) Pelvis architecture and urinary incontinence in women. Eur Urol 52:239–244CrossRefGoogle Scholar
  17. 17.
    Brown JS, Vittinghoff E, Wyman JF et al (2000) Urinary incontinence: does it increase risk for falls and fractures? Study of Osteoporotic Fractures Research Group. J Am Geriatr Soc 48:721–725CrossRefGoogle Scholar
  18. 18.
    Katz S, Ford AB, Moskowitz RW et al (1963) Studies of illness in the aged. The index of Adl: a standardized measure of biological and psychosocial function. JAMA 185:914–919CrossRefGoogle Scholar
  19. 19.
    Lawton MP, Brody EM (1969) Assessment of older people: self-management. Gerontologist 9:179–186CrossRefGoogle Scholar
  20. 20.
    Cho CY, Alessi CA, Cho M et al (1998) The association between chronic illness and functional change among participants in Comprehensive Geriatric Assessment program. J Am Geriatr Soc 46:667–682Google Scholar
  21. 21.
    Kaiser MJ, Bauer JM, Ramsch C et al (2009) Validation of the Mini Nutritional Assessment short-form (MNA-SF): a practical tool for identification of nutritional status. J Nutr Health Aging 13:782–788CrossRefGoogle Scholar
  22. 22.
    Wang JG, Zhang Y, Chen HE et al (2013) Comparison of two bioelectrical impedance analysis devices with dual energy X-ray absorptiometry and magnetic resonance imaging in the estimation of body composition. J Strength Cond Res 27(1):236–243CrossRefGoogle Scholar
  23. 23.
    Deurenberg P, Pietrobelli A, Wang ZM et al (2004) Prediction of total body skeletal muscle mass from fat-free mass or intra-cellular water. Int J Body Compos Res 2:107–113Google Scholar
  24. 24.
    Kittiskulnam P, Carrero JJ, Chertow GM et al (2017) Sarcopenia among patients receiving hemodialysis: weighing the evidence. J Cachexia Sarcopenia Muscle 8(1):57–68CrossRefGoogle Scholar
  25. 25.
    Bahat G, Tufan A, Tufan F et al (2016) Cut-off points to identify sarcopenia according to European Working Group on Sarcopenia in Older People (EWGSOP) definition. Clin Nutr 35(6):1557–1563CrossRefGoogle Scholar
  26. 26.
    Bahat G, Tufan A, Tufan F et al (2016) Cut-off points associated with different sarcopenic muscle mass definitions in Turkish population. Eur Geriatr Med 7S1:S1–S27Google Scholar
  27. 27.
    Bahat G, Tufan A, Kilic C et al (2018) Cut-off points for height, weight and body mass index adjusted bioimpedance analysis measurements of muscle mass with use of different threshold definitions. Aging Male.  https://doi.org/10.1080/13685538.2018.1499081 Google Scholar
  28. 28.
    Fess EE (1992) Grip strength. In: Casanova JS (ed) Clinical assessment recommendations, 2nd edn. American Society of Hand Therapists, Chicago, pp 41–45Google Scholar
  29. 29.
    Massy-Westropp NM, Gill TK, Taylor AW et al (2011) Hand grip strength: age and gender stratified normative data in a population-based study. BMC Res Notes 14(4):127.  https://doi.org/10.1186/1756-0500-4-127 CrossRefGoogle Scholar
  30. 30.
    Herschorn S (2004) Female pelvic floor anatomy: the pelvic floor, supporting structures, and pelvic organs. Rev Urol 6(Suppl 5):S2–S10Google Scholar
  31. 31.
    Park HJ, Choo SR, Kim SH et al (2015) Association between muscle loss and urinary incontinence in elderly Korean women. Korean J Fam Med 36(1):22–34.  https://doi.org/10.4082/kjfm.2015.36.1.22 CrossRefGoogle Scholar
  32. 32.
    Suskind AM, Cawthon PM, Nakagawa S et al (2017) Health ABC study urinary incontinence in older women: the role of body composition and muscle strength: from the health, aging, and body composition study. J Am Geriatr Soc 65(1):42–50CrossRefGoogle Scholar
  33. 33.
    Parker-Autry C, Houston DK, Rushing J et al (2017) Characterizing the functional decline of older women with incident urinary incontinence. Obstet Gynecol 130(5):1025–1032CrossRefGoogle Scholar

Copyright information

© European Geriatric Medicine Society 2019

Authors and Affiliations

  1. 1.Division of Geriatrics, Department of Internal Medicine, Istanbul Medical SchoolIstanbul UniversityIstanbulTurkey
  2. 2.Department of Public Health, Istanbul Medical SchoolIstanbul UniversityIstanbulTurkey
  3. 3.Department of CardiologyIstinye State HospitalIstanbulTurkey

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