Biomedical subjects

Y Y Ding

Publications and source records attributed to Y Y Ding.

At least 19 recordsLinked to original sources

PubMed2006

Factors associated with functional decline of hospitalised older persons following discharge from an acute geriatric unit.

INTRODUCTION: Older persons are likely to develop functional impairment following hospitalisation. Several studies in the West have examined the factors associated with functional decline following the older person's discharge from hospital but there are little data on Asian populations. This study aims to look at the associated risk factors in our local population, following admission to an acute geriatric unit. MATERIALS AND METHODS: This is a retrospective, cohort study. Patients who were discharged from an inpatient geriatric unit over a 3-month period were recruited. Data including their demographic information, functional status prior to admission and at the time of discharge, and medical conditions were obtained from the inpatient medical notes. A follow-up telephone interview was conducted at 3 months to determine the functional status of these patients at that point in time. RESULTS: Following hospitalisation, 40.4% of patients developed functional decline. Of those discharged, 29.6% showed functional decline at 3 months. The principal diagnosis, hypoalbuminaemia, tendency to fall, premorbid functional independence and the length of hospitalisation were associated with functional decline during hospitalisation, while hypoalbuminaemia, the presence of bedsores, institutionalisation, the length of hospitalisation and premorbid functional dependence were important factors associated with functional decline between the time of discharge and 3 months after. In the multivariable predictive model, independent predictors of functional decline at the time of discharge included patient's tendency to fall, premorbid functional independence and the length of hospitalisation, while the presence of bedsores was the only significant predictor of functional decline 3 months post-discharge. CONCLUSIONS: Many elderly patients developed new functional impairment following hospitalisation. Several factors were found to be associated with this functional decline, though no single predictive model similar to the other published studies was identified.

Accidental Falls↗

PubMed2004

Impact of a pharmacist consult clinic on a hospital-based geriatric outpatient clinic in Singapore.

INTRODUCTION: We study the impact of a pharmacist consult clinic on the care of elderly outpatients based on the Health Belief Model that the perceived benefits (improvement in medication knowledge, clinical status and perception) and attached barriers (cost and number of medication and adverse drug reactions) can influence health behaviour (medication compliance). MATERIALS AND METHODS: A randomised controlled study of 136 eligible patients with risk factors for non-compliance, using Zelen's design, was conducted in a hospital-based geriatric outpatient clinic from November 2001 to June 2002. All patients were assessed for outcome variables at baseline and 2 months later. RESULTS: One hundred and twenty-six patients were included in the intention-to-treat analysis. There were 104 pharmacist interventions with a physician acceptance rate of 76%. There was a significant improvement in medication knowledge with regards to indication (P = 0.03) and the composite dose, frequency and indication score (P = 0.06), as well as a decrease in residual adverse drug reactions that persisted at month 2 and cost avoidance of dollars 387.28 over 2 months. There was no significant difference in perception, clinical status or decrease in number of medications. The intervention group showed an improvement in adjusted compliance (odds ration [OR] = 2.52; 90% confidence interval [CI], 1.09 to 5.83) based on the ordered logistic regression model. Perception of severity of illness at baseline (OR = 1.30; 90% CI, 1.04 to 1.62), number of medication remembering methods (OR = 1.87; 90% CI, 1.08 to 3.25) and the use of routine habits (OR = 4.48; 90% CI, 1.51 to 13.28) and medication aids (OR = 3.68; 90% CI, 1.04 to 13.06) significantly affected compliance. CONCLUSION: The addition of a pharmacist consult clinic to the management of selected geriatric outpatients can improve compliance, with the attendant benefits of improving medication knowledge, cost avoidance and reducing residual adverse drug reactions.

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PubMed2004

Improving the diagnosis related grouping model's ability to explain length of stay of elderly medical inpatients by incorporating function-linked variables.

INTRODUCTION: This study first aimed to determine the adequacy of the Diagnosis Related Grouping (DRG) model's ability to explain (1) the variance in the actual length of stay (LOS) of elderly medical inpatients and (2) the LOS difference in the same cohort between the departments of Geriatric Medicine (GRM) and General Medicine (GM). We then looked at how these explanatory abilities of the DRG changed when patients' function-linked variables (ignored by DRG) were incorporated into the model. MATERIALS AND METHODS: Basic demographic data of a consecutively hospitalised cohort of elderly medical inpatients from GRM and GM, as well as their actual LOS, discharge DRG codes [with their corresponding trimmed average length of stay (ALOS)] and selected function-linked variables (including premorbid functional status, change in functional profile during hospitalisation and number of therapists seen) were recorded. Beginning with ALOS, function-linked variables that were significantly associated with LOS were then added into two multiple liner regression models so as to quantify how the functional dimension improved the DRGs' abilities to explain LOS variances and interdepartmental LOS differences. Forward selection procedure was employed to determine the final models. For the interdepartmental analysis, the study sample was restricted to patients who shared common DRG codes. RESULTS: 114 GRM and 118 GM patients were studied. Trimmed ALOS alone explained 8% of the actual LOS variance. With the addition of function-linked variables, the adjusted R2 of the final model increased to 28%. Due to common code restrictions, the data of 79 GRM and 78 GM patients were available for the analysis of interdepartmental LOS differences. At the unadjusted stage, the median stay of GRM patients was 4.3 days longer than GM's and with adjustments made for the DRGs, this difference was reduced to 3.9 days. Additionally adjusting for the patients' functional features diminished the interdepartmental LOS discrepancy even further, to 2.1 days. CONCLUSION: This study demonstrates that for elderly medical inpatients, the incorporation of patients' functional status significantly improves the DRG model's ability to predict the patients' actual LOS as well as to explain interdepartmental LOS differences between GRM and GM.

Age Factors↗

PubMed2001

Impaired mobility in older persons attending a geriatric assessment clinic: causes and management.

OBJECTIVES: To study the profile of older persons with impaired mobility. METHODS: A retrospective observational study that reviewed the case records of patients with impaired mobility at a geriatric assessment clinic. Data on mobility status, duration of decline in mobility, functional status, causes, intervention and short-term outcome (up to 16 weeks) were extracted and analysed. RESULTS: The study included 78 patients (42 males) with the median age of 78 years (61 to 96). About 80% had independent premorbid mobility. At presentation, this declined to 45%. Delayed consultations (more than 2 years) were found in 17% of patients. One third had associated decline in transfer, dressing, toileting or bathing, while 19% also had decline in feeding. In each patient, cause(s), many which were potentially reversible, were identified to have contributed to the immobility. More than one cause was identified in half of the patients. Interventions were prescribed in 88% of these patients. Short-term follow-up (median 7 weeks) showed that 21 had an improvement, 35 had the same and 8 had decline in mobility. There was a significant trend towards better outcome when patient presented early during their course of decline in mobility (p=0.005, linear by linear association = 0.013). CONCLUSION: Impaired mobility is a common pathway for many diseases, and is associated with significant functional decline. With proper evaluation, the offending causes can be identified. Early consultation is important for the application of appropriate intervention and can result in better outcome.

Activities of Daily Living↗

PubMed2001

Urinary retention in hospitalised older women.

INTRODUCTION: Information about urinary retention in women is scarce. We conducted a case-control study to identify the symptoms and risk factors associated with urinary retention in hospitalised older women. MATERIALS AND METHODS: Targeted history (especially lower urinary tract symptoms) and physical examination of 60 women (65 years or older) who had post-void residual urine volume (PRUV) (determined using a portable ultrasound Bladder Scan BVI-2500) of more than 100 mL were studied and compared with 60 controls. RESULTS: Symptoms of voiding difficulties had low positive predictive value (PPV) and negative predictive value (NPV), except for poor stream, which has a PPV of 100%. Only one-third of the patients with high PRUV had a palpable bladder. Associated with high PRUV were: 1) constipation [odds ratio (OR), 4.12; 95% confidence interval (CI), 1.90-8.91; P = 0.0004]; 2) urinary tract infection (UTI) (OR, 3.36; 95% CI, 1.58-7.12; P = 0.002); 3) impaired mobility (OR, 2.37; 95% CI, 1.12-4.97; P = 0.02); 4) past history of UTI (OR, 3.5; 95% CI, 1.34-9.14; P = 0.014); 5) past history of urinary retention (OR, 6.33; 95% CI, 1.72-23.33; P = 0.004); 6) stroke (OR, 2.5; 95% CI, 1.24-5.41; P = 0.017); 7) diabetes mellitus with microvascular complications (OR, 2.76; 95% CI, 1.08-7.04; P = 0.042). Applying logistic regression analysis, the three best predictive variables for high PRUV were constipation, UTI and past history of urinary retention. CONCLUSION: Symptoms (except for positive history of poor stream) and signs were unreliable in diagnosing urinary retention in hospitalised older women. Patients with the above risk factors should have their PRUV ascertained, which can be done reliably non-invasively. Early detection with appropriate intervention can potentially prevent the morbidity and mortality associated with urinary retention.

Aged↗

PubMed2000

Reliability of color Doppler ultrasound urodynamics in the evaluation of bladder outlet obstruction.

OBJECTIVES: To analyze the intrarater and interrater reliability of a newly developed noninvasive urodynamic technique based on color Doppler ultrasound for the evaluation of bladder outlet obstruction. We previously demonstrated the feasibility of this new technique. METHODS: Color Doppler ultrasound urodynamic evaluations were performed on 31 men with and without bladder outlet obstruction. An ultrasound image-directed Doppler system with a 3.75-MHz probe operated by a remote control robotic manipulator was used to obtain color scale data using the transperineal approach in men during voiding. We measured the flow velocities in the distal prostatic (V1) and membranous urethra (V2) and used them to obtain the velocity ratio (VR = V1/V2). Combining this information with simultaneous uroflowmetry, the functional cross-sectional area of the distal prostatic urethra (A1) was calculated. These parameters were independently reinterpreted by an inexperienced investigator using the color image data stored in a personal computer. The intrarater and interrater reliability for VR were assessed using a classification based on cutoff values previously shown to indicate the presence or absence of obstruction. RESULTS: The retest correlation using Spearman's rho for VR in terms of intrarater and interrater reliability was 0.95 and 0.57, respectively; that for A1 was 0.97 and 0.64, respectively. Using a VR of less than 1.1 (to indicate the absence of obstruction) and a VR greater than 1.6 (to indicate the presence of obstruction) for classification, intrarater and interrater agreement occurred in 93.6% to 96.8% and 77.4% to 83. 9% of cases, respectively. CONCLUSIONS: The color Doppler ultrasound urodynamic technique for noninvasive evaluation of bladder outlet obstruction can be performed with reasonable reliability.

Adult↗

PubMed2000

Noninvasive urodynamic evaluation of bladder outlet obstruction using Doppler ultrasonography.

OBJECTIVES: Previously we had developed a new method of noninvasive urodynamics using color Doppler ultrasound. Using this technique, we attempted to identify parameters that would diagnose bladder outlet obstruction (BOO). METHODS: Twenty-two men who underwent pressure-flow urodynamic studies were included. Color scale transperineal ultrasound and uroflowmetry data were analyzed by custom-made software. The maximum flow velocities in the entire prostatic urethra (V(0)), in the distal prostatic urethra just proximal to the external urethral sphincter (V(1)), and in the membranous urethra (V(2)) were obtained. Corresponding functional cross-sectional areas of the urethra at these three sites (A(0), A(1), and A(2)) were calculated as Qmax/V. The velocity ratio (VR), which was equal to V(1)/V(2), was also calculated as a parameter. All these parameters obtained by the velocity-flow urodynamics were compared with the Abrams-Griffiths number (AG). RESULTS: From the x-y plots obtained, VR correlated best with AG, with Spearman's rho of 0. 728. A(0) and A(1) had rho values of -0.461 and -0.708 against AG, respectively. All men with VR exceeding 1.6 had obstruction, whereas those with VR less than 1.1 did not. CONCLUSIONS: The VR was found to be the best parameter for diagnosing BOO. When prostatic urethral obstruction was present, the velocity in the prostatic urethra would be high but the velocity slows down to 62.5% or greater immediately below the sphincter. We believe that noninvasive pressure-flow-like urodynamic evaluation based on Doppler ultrasound has clear potential for diagnosing BOO.

Humans↗

PubMed1999

Functional status of the elderly in Singapore.

BACKGROUND: This study was done to look at prevalence and factors affecting functional dependence. The data in this paper were part of the 'Community Study on State of Health, Function, Cognitive and Social State of Elderly People in Singapore' conducted in Singapore between September 1992 and December 1993. PATIENTS: Four hundred and one elderly, aged 60 years and above were studied. Sixty-eight subjects (17%) were dependent in at least one function of Activities of Daily Living (ADL) as measured by the Barthel's Index (BI). RESULTS: The most common problem identified using this index was urinary incontinence. Forty subjects (10.4%) were dependent in at least one Instrumental Activities of Daily Living (IADL) function. The most common mode of transportation was by public transport, of which travelling by bus was the most common (59.9%) and mass rapid transit (MRT) was the least common (4%). Female gender and age > or = 75 were significant factors associated with dependence measured on Barthel's index but not on IADL. CONCLUSION: Results of this study were also compared with two previous surveys done in Singapore. Discrepancies in results noted could be attributed to different definitions in which the functions were assessed. We should aim to standardise the definition and measures of function in the local context in order to measure changes in the elderly population.

Activities of Daily Living↗

PubMed1998

Comparison of three methods of quantifying urethral resistance in men.

OBJECTIVES: To determine how well three methods of quantifying urethral resistance from pressure-flow plots compared in men. METHODS: The pressure-flow plots of 312 men who attended a Continence Clinic for evaluation of lower urinary tract symptoms were analyzed. The Abrams-Griffiths number (AG), detrusor-adjusted mean PURR [passive urethral resistance relation] factor (DAMPF), and group-specific urethral resistance factor (URA) were obtained for each plot. The correlation coefficients and simple regression equations were computed for AG versus DAMPF and AG versus URA. Using the provisional International Continence Society method for definition of obstruction to categorize the AG values as obstructed, equivocal, or unobstructed, we obtained the corresponding DAMPF and URA values for our study population. RESULTS: The Pearson correlation coefficient, r, for AG versus DAMPF and AG versus URA was 0.941 and 0.889, respectively. The corresponding regression equations obtained were AG = - 32.6 + (DAMPF)1.27 (95% confidence interval [CI] 1.22 to 1.32) and AG = - 16.4 + (URA) 1.67 (95% CI 1.58 to 1.77). The 5th to 95th percentiles of the DAMPF and URA for men who were obstructed (AG number more than 40) were 56 to 92 and 28 to 71, those for men who were equivocal (AG 20 to 40) were 35 to 62 and 17 to 38, and those for men who were unobstructed (AG less than 20) were 12 to 44 and 5 to 24, respectively. CONCLUSIONS: The DAMPF and URA were highly correlated to the AG in a linear fashion. Although these parameters were developed differently, they appeared to compare well. When using the DAMPF or URA to quantify urethral resistance, it was possible to estimate the corresponding AG value with reasonable confidence.

Adult↗

PubMed1998

Use of the uroflow study in the diagnosis of bladder outlet obstruction in elderly men.

The uroflow and pressure-flow data of 67 men aged 65 years or more were compared. At best, the uroflow study applying the Liverpool nomogram (25th percentile) and Bristol nomogram (OSD) diagnosed bladder outlet obstruction with sensitivity of 62.5% and 62.5% and specificity of 48.8% and 74.4% respectively. Using the 50th percentile of the Liverpool nomogram as the cut-off resulted in a negative predictive value of 100.0% allowing about 10% of men to have this diagnosis ruled out. We conclude that the uroflow study is inaccurate in diagnosing bladder outlet obstruction in elderly men. However, it can be used to rule out this condition in the small subset of men with maximum flow rates above the 50th percentile of the Liverpool nomogram.

Aged↗

PubMed1998

Self-perception of health among elderly community dwellers in Singapore.

Majority (90.5%) of the elderly living in the community in Singapore had a positive (satisfactory to good) perception of their health. This study found that age (70 years or older), recent hospitalisation, regular medical follow-up, hearing impairment, presence of chronic medical conditions (like musculo-skeletal problems, hypertension, ischaemic heart disease and chronic obstructive lung disease), impairment in activities of daily living, history of falls, those on regular medications and those with financial difficulties all adversely influenced perception of health. Those able to participate in regular outdoor leisure activities have a positive influence. Factors that did not significantly influence perception of health were gender, health-promoting activities, work, poor eyesight, cognitive impairment, urinary incontinence, diabetes, history of stroke and the ability to use public transport.

Activities of Daily Living↗

PubMed1997

Is the bladder "an unreliable witness" in elderly males with persistent lower urinary tract symptoms?

AIM: We sought to study the usefulness of lower urinary tract symptoms and postvoid residual urine volume in the diagnosis of voiding dysfunction in elderly men. METHODS: The symptoms and postvoid residual urine volume of 126 men aged 65 years or older referred for urodynamic studies were obtained. Their accuracy in the diagnosis of detrusor instability, bladder outlet obstruction and impaired detrusor contractility was quantified. RESULTS: For the diagnosis of detrusor instability, urgency and urge incontinence with frequency and/or nocturia had a sensitivity of 73.0% and a specificity of 60.0%. For the diagnosis of bladder outlet obstruction, poor stream with frequency and/or nocturia had a sensitivity of 51.9% and a specificity of 71.6%. Using poor stream and residual urine volume of more than 50 ml occurring together, the sensitivity was 31.1% and specificity was 89.7%. For the diagnosis of impaired detrusor contractility, poor stream had a sensitivity of 44.8% and a specificity of 56.7%. With residual urine volume of more than 50 ml, a sensitivity of 96.6% and specificity of 80.4% was obtained. CONCLUSION: Based on our findings, we conclude that the bladder does appear to be an "unreliable witness" in elderly men for the diagnosis of bladder outlet obstruction, though this is less so with impaired detrusor contractility. No conclusion can be drawn for the detrusor instability as we did not use ambulatory urodynamic studies.

Aged↗

PubMed1997

Epidemiology of falls among the elderly community dwellers in Singapore.

AIM: Falling is a serious medical problem for elderly persons. This study was done to look at prevalence and risk factors for falls in community dwelling elderly in Singapore. METHOD: A random sample of 3,000 persons aged 60 years and above was chosen from a database based on the 1990 population census. Letters were sent out to 2,582 subjects who had local and complete addresses. In the letter, they were informed about the purpose of the survey, and invited to participate in a questionnaire and clinical health screening at an appointed date at a polyclinic. Participants were reminded the day before their appointment by telephone, and a new appointment could be given at the subject's convenience. RESULTS: We found a prevalence rate of falls of 17.2%. Two-thirds of these had single falls, while one-third had recurrent falls, defined as having more than one fall within the previous one year. The following factors were found to be significantly associated with increase falling in the elderly: age > or = 75 years (O.R. = 1.82, 95% C.I. 0.95-3.50), female sex (O.R. = 2.5, 95% C.I. 1.40-4.48), Malay race (O.R. = 2.66, 95% C.I. 1.21-5.86), poor vision (O.R. = 1.7, 95% C.I. 0.99-2.90), Barthel's score of less than 20 (O.R. = 1.76, 95% C.I. 0.94-3.28), those taking 2 or more drugs daily (O.R. = 2.1, 95% C.I. 1.22-3.72) and the presence of hypertension (O.R. = 1.78, 95% C.I. 1.06-3.01). Fall rate is also twice as high in women as in men. At the same time, we found that women in the group we studied also tend to exercise less than the men. Fallers also had significantly more mobility and activities of daily living (ADL) disabilities (reflected by a lower Barthel's score) and this is consistent with other results. The only factor that reduced the risk of falling was regular exercise (O.R. = 1.64, 95% C.I. 0.93-2.93). CONCLUSION: In our study, we found differences between the group with single and recurrent falls. In the group with single falls, the fall tend to occur outdoors (O.R. = 2.97, 95% C.I. 1.03-8.60) and during the day (O.R. = 3.47, 95% C.I. 1.20-10.0), tend to be accidental (O.R. = 3.16, 95% C.I. 1.05-9.50) and tend to seek medical attention (O.R. = 3.68, 95% C.I. 1.23-11.0). Overall, 32 persons (46.4%) seek medical treatment after their falls, and of these, 65.6% were women. Risk factors for falls should be screened for all elderly.

Accidental Falls↗

PubMed1996

Carer-assisted intermittent urethral catheterisation in the management of persistent retention of urine in elderly women.

Carer-assisted clean intermittent urethral catheterisation is an effective and safe treatment option for persistent urinary retention in a study of 56 elderly female patients (aged 65 years and above) with cognitive impairment and other disabilities. With this method of treatment, 54% of the patients were able to void spontaneously and were continent after a median period of 6 weeks with a range of 1 to 40 weeks. Twenty-seven per cent had significant improvement in the symptoms of urinary incontinence and the residual urine volumes became progressively smaller. However, 19% failed the programme. The recovery of spontaneous voiding was found to be significantly influenced by the age of the patient, the carer performing the intermittent catheterisation and the development of catheter-related urinary tract infection. Twenty-five per cent of the study patients developed symptomatic urinary tract infection which was associated with a delay in the recovery of spontaneous voiding. Its development was also found to be significantly associated with the presence of pre-existing diabetes mellitus, the person doing the catheterisation, the presence of dementia and with more predisposing common medical conditions.

Aged↗

PubMed1996

A urodynamic analysis of age associated changes in urethral function in women with lower urinary tract symptoms.

PURPOSE: The urethral resistance relation was studied in relation to stress incontinence and detrusor instability, and used to examine age related differences in women. MATERIALS AND METHODS: We investigated women with lower urinary tract symptoms and analyzed pressure-flow plot data. RESULTS: Women with pure detrusor instability had greater detrusor pressures at urethral opening and closure than those with a stable bladder and no stress incontinence. The latter women had greater detrusor opening and closing pressures than those with a stable bladder and genuine stress incontinence at all ages. Detrusor pressures at urethral opening and closure were less in absolute terms in association with greater age. Urethral resistance was lower during voiding in women with stress incontinence. CONCLUSIONS: Our analysis showed a distinct difference in detrusor pressures at urethral opening and closure between women with and without stress incontinence. Differences were also demonstrated between women with and without detrusor instability. We found lower values of these indirect measures of urethral function in association with greater age. There was no evidence of lower urethral compliance in older women with lower urinary tract symptoms.

Adult↗

PubMed1996

Clinical utility of a portable ultrasound scanner in the measurement of residual urine volume.

BACKGROUND: Post-voiding residual urine volume is an important investigation in the management of voiding dysfunction. Catheterisation is widely regarded as the "gold" standard method of measurement. We investigated the performance of a portable ultrasound scanner (Bladder Scan BVI-2500), as an alternative method of measurement. METHODS: This study was prospective in nature. One hundred measurements of post-voiding residual urine volume by ultrasound were compared with measurements by catheterisation. RESULTS: The mean absolute error of the scanner was 52 mL. For volumes below 200 mL and 100 mL, this was 36 mL and 24 mL respectively. A decision regarding whether to decompress the bladder by catheterisation would have also been correct in 86% to 89% of instances, depending on the cut-off value of the residual volume used. In other words, the ultrasound measurement would have been correct in 9 out of 10 clinical cases. CONCLUSION: We recommend the routine use of portable ultrasound scanners of similar accuracy in the measurement of post-voiding residual urine volume.

Adult↗

PubMed1995

Oxybutynin with bladder retraining for detrusor instability in elderly people: a randomized controlled trial.

The aim of this study was to examine the efficacy of oxybutynin plus bladder training in the treatment of detrusor instability in frail elderly patients living independently in the community. It was a randomized, double-blind, placebo-controlled parallel-group trial of oxybutynin in 57 elderly patients (mean age 82.2, SD 6.06), with frequency and incontinence due to detrusor instability. After a 2-week run-in period patients received a bladder training and drug or placebo for the next 6 weeks. Outcome measures were changes in frequency and incontinence, recorded throughout on diary charts, and subjective evaluation of symptoms ('better'/'not better', and using a four-point scale 'cure' to 'no change'). Oxybutynin was superior to placebo in reducing daytime frequency [95% confidence interval (CI) of difference in change in frequencies totalled over 14 days was -27.0, -6.0; p = 0.003] and in producing subjective benefit (at day 29 only), when 24/28 (86%) patients on oxybutynin described benefit compared with 16/29 (55%) on placebo (p = 0.02). There was no difference between the groups in reduction of incontinent episodes. The median dose of oxybutynin titrated for therapeutic effect was 5 mg/day, and for placebo 10 mg/day (CI of difference 0.001, 5.001; p = 0.05). Side-effects reported were of similar frequency (50%) in the two groups. We conclude that oxybutynin with bladder training is superior to bladder training alone in reducing frequency due to detrusor instability in very elderly people living at home.

Aged↗

PubMed1994

Urinary incontinence in the hospitalised elderly--a largely reversible disorder.

A five-month prospective study of urinary incontinence in the elderly was carried out in an acute assessment and rehabilitation geriatric ward to determine the incidence, underlying causes and outcome with management. The incidence in patients 65 years or older was 22%. Of these, 21% had transient incontinence which resolved after the precipitating medical cause was treated. Incontinence was resolved in 36% and improvement obtained in another 20%. Management of urinary incontinence in this population can result in a satisfactory outcome in more than half of patients and is worth pursuing.

Aged↗