Functional status in older women diagnosed with pelvic organ prolapse.

TitleFunctional status in older women diagnosed with pelvic organ prolapse.
Publication TypeJournal Article
Year of Publication2016
AuthorsSanses, TVD, Schiltz, NK, Couri, BM, Mahajan, ST, Richter, HE, Warner, DF, Guralnik, JM, Koroukian, SM
JournalAm J Obstet Gynecol
Volume214
Issue5
Pagination613.e1-7
Date Published2016 May
ISSN Number1097-6868
KeywordsActivities of Daily Living, Aged, Aged, 80 and over, Aging, Cross-Sectional Studies, Female, Health Status, Health Surveys, Humans, Medicare, Middle Aged, Mobility Limitation, Muscle Strength, Pelvic Organ Prolapse, United States, Upper Extremity
Abstract

BACKGROUND: Functional status plays an important role in the comprehensive characterization of older adults. Functional limitations are associated with an increased risk of adverse treatment outcomes, but there are limited data on the prevalence of functional limitations in older women with pelvic floor disorders.

OBJECTIVE: The aim of the study was to describe the prevalence of functional limitations based on health status in older women with pelvic organ prolapse (POP).

STUDY DESIGN: This pooled, cross-sectional study utilized data from the linked Health and Retirement Study and Medicare files from 1992 through 2008. The analysis included 890 women age ≥65 years with POP. We assessed self-reported functional status, categorized in strength, upper and lower body mobility, activities of daily living (ADL), and instrumental ADL (IADL) domains. Functional limitations were evaluated and stratified by respondents self-reported general health status. Descriptive statistics were used to compare categorical and continuous variables, and logistic regression was used to measure differences in the odds of functional limitation by increasing age.

RESULTS: The prevalence of functional limitations was 76.2% in strength, 44.9% in upper and 65.8% in lower body mobility, 4.5% in ADL, and 13.6% in IADL. Limitations were more prevalent in women with poor or fair health status than in women with good health status, including 91.5% vs 69.9% in strength, 72.9% vs 33.5% in upper and 88.0% vs 56.8% in lower body mobility, 11.6% vs 0.9% in ADL, and 30.6% vs 6.7% in IADL; all P < .01. The odds of all functional limitations also increased significantly with advancing age.

CONCLUSION: Functional limitations, especially in strength and body mobility domains, are highly prevalent in older women with POP, particularly in those with poor or fair self-reported health status. Future research is necessary to evaluate if functional status affects clinical outcomes in pelvic reconstructive and gynecologic surgery and whether it should be routinely assessed in clinical decision-making when treating older women with POP.

URLhttp://www.sciencedirect.com/science/article/pii/S0002937815024783
DOI10.1016/j.ajog.2015.11.038
User Guide Notes

http://www.ncbi.nlm.nih.gov/pubmed/26704893?dopt=Abstract

Endnote Keywords

activities of daily living/functional status/limitations/mobility/pelvic organ prolapse/strength

Endnote ID

999999

Alternate JournalAm J Obstet Gynecol
Citation Key8397
PubMed ID26704893
PubMed Central IDPMC4851569
Grant ListR21 HS023113 / HS / AHRQ HHS / United States
KL2 TR000440 / TR / NCATS NIH HHS / United States
K12 HD043489 / HD / NICHD NIH HHS / United States
P30 AG028747 / AG / NIA NIH HHS / United States
UL1 TR000439 / TR / NCATS NIH HHS / United States
R01 AG048069 / AG / NIA NIH HHS / United States