特別養護老人ホーム入所者の尿失禁に関する実態調査

Abstract

1)特別養護老人ホームに入所中の老人98名(女77名, 男21名, 平均年齢78.8歳)のうち, 尿失禁を47名に認め, そのうちdiaperを必要とする高度の尿失禁を有するものは21名であった.2)痴呆および日常動作の障害の悪化と, 尿失禁の程度の間に有意の相関を認め, 痴呆ならびに日常動作の制限は尿失禁の大きなリスクファクターと考えられた.3)排尿筋の無抑制収縮の有無と, 痴呆ならびに尿失禁との間にそれぞれ有意の相関を認め, 痴呆に伴って引き起こされる排尿筋の反射亢進が尿失禁の大きな原因となっていると思われた

We assessed the prevalence of urinary incontinence and contributory factors such as senile dementia, impaired mobility, medication, associated disorders and urinary tract infection in 98 elderly residents of a nursing home. The residents' mean age was 79 years, and 78% were women. Urinary incontinence was found in 47 (48%), of whom 21 had severe urinary incontinence for which they needed to wear diapers. Senile dementia and impaired mobility were observed in 53 (54%) and 45 (46%), respectively. We also found that those with both dementia and impaired mobility had significantly (p less than 0.01) precipitated urinary incontinence. However, no significant effects on urinary incontinence were observed for associated disorders, medication or urinary tract infection. A cystometrogram performed in 73 of the 98 residents revealed detrusor overactivity in 47%. In addition, there were significant correlations between the incidence of detrusor overactivity, and the prevalence of dementia or urinary incontinence. These results suggest that senile dementia and immobility are independent risk factors for urinary incontinence in the elderly, and that detrusor overactivity, which was found to be associated with senile dementia, is a possible cause of urinary incontinence.