May 13, 2010 – Pelvic floor muscle problems cause urinary incontinence in women over 60, but cognitive impairment and weakened lower limb muscles may also be involved, says Chantal Dumoulin1 from the Research Center of the Montreal Geriatric Institute.
She presented the results of her research within the framework of the 78e Congress of the Association francophone pour le savoir1 (Acfas), which takes place in Montreal2.
The conclusions of 3 separate studies led Chantal Dumoulin’s team to link mixed urinary incontinence in elderly patients with pelvic floor problems, certain cognitive disorders and problems with balance and strength and posture due to weakening of the muscles of the lower limbs.
Chantal Dumoulin
Mixed urinary incontinence is associated with at least 2 forms of this disorder. The most common combination is that of stress incontinence – the most common – and urge incontinence (overactive bladder).
The first research looked at the possible association between mixed urinary incontinence and pelvic muscle dysfunction. The problem more frequently troubles young women, particularly as a result of muscle trauma after childbirth, specifies Ms. Dumoulin. The cohort consisted of 89 women over the age of 60, including 23 participants without periods of urinary incontinence in the past year and 66 patients with mixed urinary incontinence. Researchers found several pelvic floor muscle abnormalities in those who had urinary incontinence, similar findings to younger women.
The second study explored the suspected correlation between the severity of urinary incontinence, balance and lower limb strength. More than 100 women who suffered from urinary incontinence took a questionnaire and participated in physical tests aimed at leg bending and balance exercises. The failure of these exercises has shown that weakened muscles in the lower limbs are particularly handicapped in the elderly with incontinence, especially those over 70 years of age.
Incontinence associated with cognitive impairment
A third study investigated whether older women with mixed urinary incontinence also had cognitive decline. The researchers recruited 115 women, including 83 with mixed urinary incontinence and 32 continent participants.
The results revealed that serious cognitive impairment is also present in cases of urinary incontinence, especially executive functions. Executive functions relate to the coordination of decision-making factors, such as planning, coordination, and other essential functions. The tests especially demonstrated the difficulty for patients to perform 2 tasks at the same time, continues the specialist.
Her research team is currently preparing adapted and specialized exercises for improving physical strength and cognition in incontinent women. “We specifically target muscle strengthening through walking and balance exercises,” explains Chantal Dumoulin, in addition to repetitions of floor exercises to work the pelvic muscle. His team wants to design a training dedicated to improving cognitive abilities.
Studies on urinary incontinence are rare, says Chantal Dumoulin. However, the results show a significant prevalence of urinary incontinence. “At 60, 55% of women suffer from it and, among these, 20% to 25% show significant symptoms,” explains the researcher. The social and economic impacts are also important, since incontinent women fall 3 times more than women without urinary problems.
Danny Raymond – HealthPassport.net
1. Chantal Dumoulin is also an associate professor at the School of Rehabilitation of the University of Montreal.
2. The Acfas congress will take place from May 10 to 14, 2010, at the University of Montreal. For more information: www.acfas.ca.
