Adverse Social Determinants of Health and Urinary Incontinence Among Older Adult Women in Home Health Care.
Danielle Scharp, Mollie Hobensack, Jiyoun Song and 4 others
PMID 40947102WHAT IT FOUND
Older women in home health care with documented unsafe housing, financial strain, or food insecurity were more likely to have urinary incontinence.
Ask about these social risks and consider continence evaluation and home modifications.
Key findings
01About 57% of the home health care episodes were for women with urinary incontinence.
02Documentation of problems with the physical environment and economic circumstances was associated with the highest adjusted odds of urinary incontinence.
03Documentation of food insecurity was also associated with higher adjusted odds of urinary incontinence.
STILL TO COME
How it was doneWhat they foundWhat it means for OTsWhat it means for RNs
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What it does not show
The study was cross-sectional, so it cannot show that social risks caused urinary incontinence. The dataset did not include urinary incontinence subtype, so stress, urgency, mixed, and overflow incontinence could not be compared. The sample came from one home health care agency in New York, so results may not apply to other settings, men, or younger patients. Social risks were identified from clinical notes and natural language processing, so some risks may have been missed if not reported or documented. Each social risk domain was treated as present or absent, without frequency, severity, or co-occurrence. Data were from 2015 to 2017, which may not reflect current urinary incontinence medications, continence products, or care approaches. The study could not examine anxiety or depression as mediators because validated measures were not available.
Declared interests
The authors reported no conflicts of interest.
The easy way to misread this
Do not conclude that unsafe housing, financial strain, or food insecurity caused urinary incontinence. The study was cross-sectional and measured associations in records, not a treatment effect.