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Objective To identify sociodemographic, clinic profile and factors associated with low back pain (LBP) in women who consult for this reason. Methods Cross-sectional study carried 28 October 2010 and 29 April 2011 out in 2 primary care centers in Cordoba and 1 private center in Madrid. A total of 364 women participated, with ages 20–65 years (of the 466 women contacted, 33 were excluded for inability to contact them, 29 did not attend the interview and 40 refused to participate). These women had consulted because of back pain located between the twelfth rib and the gluteal fold, with or without pain that went down the leg. They were interviewed by means of a questionnaire and the performance test was evaluated by Active Straight Leg Raise (ASLR) test. Outcome measures Presence and intensity of LBP, Oswestry Disability Index (ODI), number of births, urinary incontinence (UI), ASLR test, digestive, respiratory and osteoarticular comorbidity, diabetes, high blood pressure, drugs, physical activity and sociodemographic data. A descriptive and multivariate statistical analysis was performed. Results Mean age 46 years, 24% with chronic pain, 43% with UI and positive ASLR and 39% severe disability grade (ODI > 40%). In the multivariate analysis the variables associated with severe disability caused by LBP were sciatica (OR 7.439; 95% CI: 3.979–10.898), osteoarthritis (OR 3.366; 95% CI: −0.312 to 7.044), LBP intensity (OR 3.094; 95% CI: 2.303–3.885), ASLR+ (OR 2.313; 95% CI: 1.599–3.027), increased use of drugs (OR 0.811; 95% CI: 0.114–1.517) and IU (OR 0.407; 95% CI: 0.073–0.741). Conclusions 39% of women have severe incapacity that is related to the presence of sciatica, osteoarthritis, LBP intensity, ASLR+, drugs and IU.

ObjetivoDeterminar, en un período de 5 años, la prevalencia, la incidencia, la remisión, los patrones de cambio de la incontinencia urinaria (IU) y los factores asociados con los cambios en el estatus de continencia.DiseñoEstudio longitudinal prospectivo.EmplazamientoZona Básica de Salud de Cabra (Córdoba).ParticipantesUn total de 827 sujetos seleccionados en 1996 entre 5.139 personas ≥65 años mediante muestreo aleatorio estratificado por grupos de edad y seguidos entre 1996 y 2001.IntervencionesEncuesta domiciliaria.Mediciones.Preguntas sobre detección y severidad de la IU, datos sociodemográficos y valoración funcional. Se analizaron las variables explicativas para la probabilidad de estar vivo y desarrollar IU a los 5 años, respectivamente.ResultadosLa prevalencia de IU fue del 36% en 1996 y del 46% en 2001. La mortalidad fue similar en continentes eincontinentes. El 54,5% de los sujetos continentes en 1996 permaneció igual en 2001. Las tasas de incidencia y remisión alos 5 años fueron del 29 y 15%, respectivamente. En ambos sexos, la incontinencia ligera y moderada evolucionó principalmente hacia grados moderados y severos, mientras que la IU severa permaneció sin cambios en el 40,1%. La autopercepción de salud y la situación funcional son las principales variables queinfluyen tanto en la supervivencia como en la incidencia de IU.ConclusionesLa prevalencia de IU es alta, la incidencia es moderada y la remission espontánea baja. La IU es un problema dinámico y no afecta la mortalidad. Eldeterioro de la movilidad influye fuertemente en la incidencia de IU.ObjectiveTo determine prevalence, incidence and remission rates and change patterns of urinary incontinence (UI) over a 5-year time span.DesignLongitudinal study.LocationBasic Health Zone of Cabra (Córdoba).PatientsA random age-stratified sample of 827 subjects selected from a total of 5139 persons ≥65 years of age and followed up between 1996 and 2001.InterventionsHome interview.MeasurementsQuestions about detection and level of severity of UI, sociodemographic data, and level of functioning. Two logistic regression models were created to identify risk factors for the probability to be alive and to develop UI, respectively.ResultsUI prevalence reached 36% at baseline and 46% five years later. Mortality rates were similar in continent and incontinent subjects. 54.5% of continent subjects in 1996 remained so in 2001. Five-year incidence and remission rates were 29% and 15%, respectively. In both sexes, slight and moderate incontinence mainly progressed to moderate and severe degrees, whereas severe UI remained unchanged in 40.1%. The main risk factors for increased survival and for UI incidence were self-rated health and level of functioning.ConclusionsPrevalence of UI is high, incidence is moderate and remission is low. Urinary incontinence is a dynamic problem and does not affect mortality. Impaired mobility has a strong influence on UI incidence.

OBJECTIVE To determine prevalence, incidence and remission rates and change patterns of urinary incontinence (UI) over a 5-year time span. DESIGN Longitudinal study. LOCATION Basic Health Zone of Cabra (Cordoba). PATIENTS A random age-stratified sample of 827 subjects selected from a total of 5139 persons > or = 65 years of age and followed up between 1996 and 2001. INTERVENTIONS Home interview. MEASUREMENTS Questions about detection and level of severity of UI, sociodemographic data, and level of functioning. Two logistic regression models were created to identify risk factors for the probability to be alive and to develop UI, respectively. RESULTS UI prevalence reached 36% at baseline and 46% five years later. Mortality rates were similar in continent and incontinent subjects. 54.5% of continent subjects in 1996 remained so in 2001. Five-year incidence and remission rates were 29% and 15%, respectively. In both sexes, slight and moderate incontinence mainly progressed to moderate and severe degrees, whereas severe UI remained unchanged in 40.1%. The main risk factors for increased survival and for UI incidence were self-rated health and level of functioning. CONCLUSIONS Prevalence of UI is high, incidence is moderate and remission is low. Urinary incontinence is a dynamic problem and does not affect mortality. Impaired mobility has a strong influence on UI incidence.

ObjetivoConocer la frecuencia con que las personas ancianas con incontinencia urinaria (IU) comunican este problema a los profesionales de atención primaria, las variables asociadas a la no comunicación y los hábitos diagnósticos y terapéuticos de dichos profesionales.DiseñoEstudio transversal.EmplazamientoZona Básica de Salud de Cabra (Córdoba).PacientesUn total de 869 seleccionados entre 5.139 personas de ≥ 65 años mediante muestreo aleatorio estratificado por grupos de edad.IntervencionesEncuesta domiciliaria.MedicionesCuestionario propio con preguntas sobre la comunicación de la incontinencia a los sanitarios y sobre el cribado rutinario y la evaluación diagnóstica y terapéutica de la incontinencia por dichos profesionales. Modelo de regresión logística para identificar los factores explicativos de la búsqueda de ayuda profesional.ResultadosUn 32% de los 330 incontinentes del estudio comunicó su problema a los sanitarios y el 68% restante no lo hizo, porque en su mayoría piensan que la incontinencia tiene escasa importancia y/o que ocurre con la vejez. Los factores explicativos de la comunicación fueron la frecuencia, la duración y el impacto de la incontinencia, y la dependencia en el autocuidado. Los médicos habían investigado rutinariamente la existencia de incontinencia en un 10% de los 827 encuestados. En uno de cada 5 incontinentes el médico no adoptó ninguna medida diagnóstica ni terapéutica.ConclusionesLa búsqueda de ayuda médica para la IU fue escasa y depende de variables relacionadas con la percepción en los cambios de los síntomas. El diagnóstico y el tratamiento que realizan los profesionales es subóptimo. La severidad de la IU condiciona el diagnóstico y el tratamiento.ObjectiveTo investigate the frequency in which aged people who suffers on urinary incontinence (UI) talk about this problem with primary care professionals, variables related to no healthcare-seeking as well as diagnostic and therapeutic habits of these professionals.DesignCross-sectional study.LocationBasic Health Zone of Cabra (Córdoba, Spain).PatientsA random age-stratified sample of 869 patients selected from a total of 5139 persons ≥ 65 years of age.InterventionsHome interview.MeasurementsProper questionnaire with questions about reporting of incontinence to health professionals and the procedures used for routine screening as well as diagnostic and therapeutic assessment of incontinence. A logistic regression model was elaborated to identify explanatory factors for reporting incontinence to healthcare professionals.ResultsOf 330 incontinents, only 32% reported their problem to healthcare professionals. The remaining 68% did not report their incontinence because most thought it was a minor problem and/or part of the ageing process. The explanatory factors for seeking medical help were the frequency, duration and impact of incontinence, and dependence in self-care. Physicians performed routine screening for incontinence in 10% of 827 inquired aged. In 1 out of 5 incontinents, the physician did not take any diagnostic or therapeutic measures.ConclusionsSeeking of UI medical help was very limited and depends on variables related to perception in symptom’s changes. Diagnosis and treatment done by professionals was suboptimal. Severity of UI conditions diagnosis and treatment.

Objective: to evaluate the associations of 18 activities of daily living with self-rated health in older people. Design and setting: cross-sectional study of a representative sample of 781 people aged 65 or over (response rate: 89.9%). Methods: self-rated health was assessed by the question: ‘‘Overall, how would you rate your current health status—very good, good, fair, poor or very poor?’’ We used the Barthel index and Lawton and Brody’s index for basic and instrumental activities of daily living, respectively. We classified subjects into three groups according to their Barthel index score: level 1 (score 100), level 2 (score 91‐99) and level 3 (score 0‐90). Logistic regression was used to identify associations between each activity and self-rated health. Results: use of stairs [odds ratio (OR) = 4.28, 95% confidence interval (95% CI): 2.82‐6.52], ambulation (OR = 3.67, 95% CI: 2.39‐5.64) and chair/bed transfer (OR = 3.00, 95% CI: 1.68‐5.36) were the basic activities of daily living best associated with self-rated health. Among instrumental activities of daily living, ability to handle finances (OR = 2.20), laundry (OR = 2.15) and transport (OR = 2.12) were associated with self-rated health. On the Barthel index, only transport was associated with self-rated health in subjects at levels 1 (OR = 2.55) and 2 (OR = 2.72). For subjects with poor functional status (level 3), no instrumental activities of daily living were related to self-rated health. Conclusion: in terms of self-rated health, the most important activities of daily living were those involving mobility. The effect of each instrumental activity of daily living on self-rated health depends on the level of functional capacity in basic activities of daily living.

ObjetivosEstudiar la proporcion y caracteristicas de los ancianos que utilizan accesorios para incontinencia urinaria y calcular el coste economico de los absorbentes.DisenoEstudio transversal.EmplazamientoZona Basica de Salud de Cabra (Cordoba).PacientesUn total de 827, entre 5.139 personas. 65 anos, seleccionados mediante muestreo aleatorio estratificado por grupos de edad.Mediciones y resultados principalesCuestionario especifico sobre incontinencia urinaria e indices de Barthel y de Lawton. Analisis economico de los absorbentes consumidos.Se utilizaron dos fuentes de datos: encuesta domiciliaria, con recogida de informacion sobre uso de accesorios y el fichero de visado de absorbentes de la Zona Basica de Salud de Cabra.Se detecto incontinencia urinaria en un 36% de los ancianos. El 63% de los incontinentes utilizaba algun accesorio, un 8,1% usaba absorbentes y el 2,9% cateter uretral. El uso de accesorios se asocio a edad avanzada, genero femenino y dependencia funcional.En 1996 el coste de los absorbentes en la Zona Basica de Salud de Cabra fue de 19.416.298 pts. y de 51.639 por anciano incontinente.ConclusionesLa prevalencia global del uso de accesorios fue superior o similar a la de otros estudios sobre incontinencia y la de absorbentes menor. El coste medio de los absorbentes por anciano durante 1996 represento un 49% del coste maximo permitido por la Inspeccion Sanitaria.AimsTo study the proportion and characteristics of elderly people who use aids for urinary incontinence, and the economic cost of pads.DesignCross-sectional study.InterventionsA specific questionnaire on urinary incontinence and Barthel and Lawton indexes; and economic analysis of the number of pads used.LocationBasic Health Zone of Cabra (Cordoba).Patients827, among a total of 5139. 65 years-old subjects, by means of a random sampling, classified in age groups.MeasurementsTwo sources of data were used: a home health interview gathering information about the use of aids; the register which controls the prescription of pads in the Basic Health Zone of Cabra.Main resultsUrinary incontinence was detected in 36% of elderly people. Sixty-three percent of the incontinent people used some sort of aid, 8.1% used pads and 2.9% used an urethral catheter. The use of aids was related to advanced age, female gender and functional dependence.In 1996, the cost of the pads was 19416298 pesetas and 51659 pesetas per incontinent person.ConclusionsThe overall prevalence of the use of aids was greater than or similar to that of other studies whereas the use of pads was less. During 1996 the average cost of the pads per elderly person amounted to 49% of the theoretical maximum cost permitted by the health authority.

ObjetivosConocer la opinion de los ancianos de una zona basica de salud acerca de las expectativas de curacion de la incontinencia urinaria.DisenoEstudio transversal.IntervencionesCuestionario especifico sobre incontinencia urinaria e indice de Barthel modificado por Shah.EmplazamientoZona Basica de Salud de Cabra (Cordoba).PacientesUn total de 793 seleccionados entre 5.139 personas. 65 anos mediante muestreo aleatorio estratificado por grupos de edad.MedicionesEncuesta domiciliaria sobre incontinencia urinaria (presencia, caracteristicas, opinion referente a las expectativas de curacion).Resultados principalesPara un 48% de los ancianos la incontinencia se puede curar, para el 21% se puede mejorar, el 9% manifiesta que no se puede hacer nada y el 22% restante no tiene opinion. Se pone de relieve una asociacion significativa entre el tipo de respuesta obtenido y la edad, sexo, salud tal como la percibe el sujeto y nivel de cuidado personal. El ser incontinente no influyo en el caracter de las respuestas dadas sobre las posibilidades de exito del tratamiento de la incontinencia.ConclusionesNuestros ancianos no estan al tanto de las posibilidades que ofrece el tratamiento de la incontinencia, hecho que puede contribuir negativamente a la busqueda de ayuda para solucionar este remediable problema.AimsTo determine the attitudes of community-dwelling elderly patients about the possibilities for cure of urinary incontinence.DesignCross-sectional study.InterventionsA specific questionnaire on urinary incontinence and the Barthel Index modified by Shah.LocationBasic Health Zone of Cabra (Cordoba, Spain).PatientsA random age-stratified sample of 793 patients selected from a total of 5139 persons. 65 years of age.MeasurementsHome interview on urinary incontinence (presence, characteristics, patient attitude regarding possibilities for cure).Principal resultsForty-eight percent of elderly persons felt that incontinence could be cured, 21% thought that it could be improved, 9% stated that nothing could be done about it and the remaining 22% had no opinion. A significant association was found between the type of response and age, sex, state of health as perceived by the subject and level of self-care. The presence of incontinence did not influence the nature of the responses given by patients about the possibilities for successful treatment of incontinence.ConclusionsOur elderly persons were not aware of the possibilities for treatment of incontinence, a fact that may have a negative impact on sufferers seeking help for this remediable problem.

Background. The prevalence and the psychosocial impact of urinary incontinence in older people of a rural population were investigated. Methods. A cross-sectional study was made by means of a home health interview in a representative sample of people aged 65 years and older in the Basic Health Zone of Cabra (Cordoba). A questionnaire was used with two questions to detect urinary incontinence and further questions regarding its duration, frequency, volume, severity and psychosocial impact. Data were analyzed with basic statistics. A logistic regression model was created to identify which factors affect people’s lifestyles. Results. Among the 827 respondents the prevalence of incontinence reached 36% [95% confidence interval (CI): 34%‐38%] and was higher ( p , .001) in women (42%; 95% CI: 39%‐45%) than in men (29%; 95% CI: 25%‐38%). The most frequent duration of incontinence was from 1 to 5 years (16.8%). Fifteen percent had daily episodes and 10.6% estimated the volume of urine loss as high. Incontinence was severe in 9% of the affected subjects. Half the incontinent subjects expressed social limitations and negative feelings related to incontinence, and 21% admitted that incontinence negatively affected their lives. In the logistic regression model, both volume of urine loss [odds ratio (OR) 5 5.61; 95% CI: 2.76‐11.42] and being married (OR 5 2.34; 95% CI: 1.03‐5.33) were the factors statistically associated with a negative influence of incontinence on lifestyle. Conclusions. Urinary incontinence is a very frequent symptom in our population. Half the incontinent subjects suffer from some degree of psychosocial limitation. The volume of urine loss and being married are the most important factors with psychosocial impact.