TY - JOUR
T1 - Functional status in older women diagnosed with pelvic organ prolapse
AU - Sanses, Tatiana V.D.
AU - Schiltz, Nicholas K.
AU - Couri, Bruna M.
AU - Mahajan, Sangeeta T.
AU - Richter, Holly E.
AU - Warner, David F.
AU - Guralnik, Jack
AU - Koroukian, Siran M.
N1 - Funding Information:
This study was supported by American Urogynecologic Society Surgical Award Grant 2013; Division of Female Pelvic Medicine and Reconstructive Surgery, University Hospitals Case Medical Center; Clinical and Translational Science Collaborative of Cleveland , UL1TR000439 (Dr Koroukian) and KL2TR000440 (Dr Schiltz) from the National Center for Advancing Translational Sciences component of the National Institutes of Health ; research grants from Allergan Inc (Dr Mahajan) and Pelvalon (Dr Richter); Building Interdisciplinary Research Careers in Women’s Health, Eunice Kennedy Shriver National Institute of Child Health and Human Development K12 HD43489 (Dr Sanses); and grants from the Agency for Healthcare Research and Quality R21 HS023113 (Drs Warner and Koroukian) and the National Institute on Aging R01 AG048069 (Dr Guralnik).
Publisher Copyright:
© 2016 Elsevier Inc. All rights reserved.
PY - 2016/5/1
Y1 - 2016/5/1
N2 - 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.
AB - 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.
KW - activities of daily living
KW - functional status
KW - limitations
KW - mobility
KW - pelvic organ prolapse
KW - strength
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U2 - 10.1016/j.ajog.2015.11.038
DO - 10.1016/j.ajog.2015.11.038
M3 - Article
C2 - 26704893
AN - SCOPUS:84964467795
SN - 0002-9378
VL - 214
SP - 613.e1-613.e7
JO - American Journal of Obstetrics and Gynecology
JF - American Journal of Obstetrics and Gynecology
IS - 5
ER -