Association between urinary urgency and falls among rural dwelling older women

Aim To examine the association between urinary urgency and falls in older women living in rural areas in South Korea. Design A secondary analysis was conducted using cross‐sectional data. Methods This study used dataset obtained from 246 women aged 65 years or older living in 15 rural mountain communities in South Korea between February 2016–March 2016. Falls were measured by self‐reports including the number, location, reasons of falls during the past year. Frequency of urinary urgency and nocturia were assessed by self‐reports. Covariates included age, body mass index, self‐reported health problems. Mixed‐effects negative binomial regression was used to analyse the association between urinary urgency and the number of falls. Results The mean age of the 246 women was 77.3 years. Among the sample, 30.1% experienced at least one fall in the past year and 16% had required hospital treatments. The analysis showed that urinary urgency and osteoporosis were significantly associated with a greater number of falls after adjusting for other covariates. Among those who had experienced falls, nearly 60% reported that the reasons for falls were environmental factors, such as slippery floors or uneven sidewalks/thresholds. Conclusion Improving urinary urgency may be a strategy to decrease the fall risk in older women. Accordingly, community nurses can provide intervention programs on lifestyle and behavioural changes such as bladder training, dietary modification and pelvic floor muscle training. Interventions for fall prevention need to be developed while considering the unique features of indoor and outdoor environments. Impact The findings have implications for healthcare providers and policy makers with regard to the development of safer indoor and outdoor environments for older women living in rural areas by remodelling their residential spaces and neighbourhoods. In addition, more prospective studies using larger samples are needed to investigate the causal mechanism between urinary urgency and falls. 目的 对居住在韩国农村地区的老年妇女尿急症与跌倒的关系进行研究。 设计 采用横向数据进行二次分析。 方法 本项研究所用数据集来源于2016年2月至2016年3月居住在韩国15个农村山区社区的246名65岁及以上妇女。跌倒情况通过自我报告方式予以判定,包括过去一年内跌倒的次数、地点、原因。通过自我报告方式来对尿急症和夜尿症的发生次数进行评价。协变量包括年龄、体重指数、自我报告的健康问题。同时采用混合效应负二项回归来分析尿急症与跌倒次数之间的关系。 结果 246名妇女的平均年龄为77.3岁。在样本中,30.1%的妇女在过去一年中至少有过一次跌倒经历,另有16%跌倒后需要住院治疗。分析表明,在调整其他协变量后,尿急症和骨质疏松症与较多跌倒次数显著相关。在有过跌倒经历的妇女中,约60%表示,跌倒原因在于环境因素,如地面太滑或人行道/门槛不平。 结论 改善尿急症可作为降低老年妇女跌倒风险的策略之一。因此,社区护士可提供生活方式和行为改变相关干预计划,如膀胱训练、饮食调整和盆底肌训练。在考虑室内和室外环境的特殊特点的同时,还需要制定预防