A comparative study on prevalence of urinary incontinence among elderly living in community, pondok and old folks home in Kelantan. Hami R1 , Mohd Hashim MH2, Norsa’adah B3, Azidah AK4, Hasanah CI5. 1 Advance Medical and Dental Institute USM 13200 Kepala Batas Pulau Pinang 2 Department of Community Medicine USM 16150 Kubang Kerian Kelantan 3 Research Methodology and Biostatistic Unit USM 16150 Kubang Kerian Kelantan 4 Department of Family Medicine USM 16150 Kubang Kerian Kelantan 5 Department of Psychiatry USM 16150 Kubang Kerian Kelantan

Content Introduction Objective Methodology Result Discussion Limitation Recommendation Conclusion

Introduction Urinary incontinence is the complaint of involuntary leakage of urine. As the population ages, the numbers of older people with urinary incontinence will significantly increase. Urinary incontinence is classified as a major category of impairment that appear in elderly people, especially as they begin to fail and it is one of the Giants of Geriatrics.

Objective General objective : To determine the prevalence of urinary incontinence among elderly living in community, pondok and old folks home in Kelantan Specific objective : To compare the prevalence of urinary incontinence among elderly living in community, pondok and old folks home in Kelantan

Methodology Study design : Cross sectional Study population : Elderly in Kelantan Source population :Elderly living in districts of Kota Bharu, Pasir Mas, Rantau Panjang, Bachok, Pasir Puteh and Machang. Sampling frame :Elderly living in community, pondok and old folks home in the districts mention above. Inclusion criteria : Elderly age 60 and above and consented to take part . Exclusion criteria : Elderly who were unable to understand or speak Bahasa Melayu or English language. Elderly who were deaf and mute, elderly with aggressive behaviour also excluded from this study.

Methodology 471 respondents were participated in this comparative cross-sectional study conducted in Kelantan. 157 each from community, pondok and old folks home. Urinary incontinence was assessed using validated Malay version of 10 minute comprehensive screening developed by The Department of Ageing and Life Course (ALC) to diagnosis and manage the Giants of Geriatrics (WHO 2007). The prevalence of urinary incontinence were compared between the living place using chi-square tests. Urinary incontinence last week   55(11.7) 19 (12.1) 17 (10.8) 0.165(2) 0.921

Results Table 1: Comparison of urinary incontinence between living place (n=471)   Variable Living place n(%) X2 (df) p value* Total frequency (%) Community (n=157) Pondok Old folks home Urinary incontinence 83(17.6) 35 (22.3) 22 (14.0) 26(16.6) 3.890(2) 0.143 The total prevalence of urinary incontinence was 17.6%. The highest prevalence was among community elderly with 22.3%. The lowest prevalence was among pondok elderly (14.0%). Whereas the prevalence of urinary incontinence for old folks home elderly was 16.6%. There was no significant difference (χ2(2) =3.890,p=0.143) in the prevalence of urinary incontinence of respondent according to living place. *Pearson chi square test

Discussion The prevalence of urinary incontinence among community elderly in this study was 22.3%. It was higher than the prevalence found in study by Sidik et al. (2004) where the prevalence was 9.9%. Incontinence in elderly was regarded as aging process and the elderly usually did not seek any medical advice for the problem. There was no significant difference between the community, pondok and old folks home respondents in the prevalence of urinary incontinence.

Discussion Community elderly had higher prevalence (22.3%) than old folks home respondents (16.6%). This finding was contradicted study by Aggazzotti et al. (2000) and Xu and Kane (2013) where more than half old folks home elderly had urinary incontinence with the prevalence of 54.5% and 65.8% respondents.

Limitation Face to face interview makes some of the elderly feel embarrassed to admit that they have incontinence problem. Denial of reality makes some of the elderly in old folks home refused to admit that they have incontinence problem. This lead to low prevalence of urinary incontinence among them in this study.

Recommendation Awareness should be given to elderly that there is treatment for urinary incontinence. Medical practitioner should address urinary incontinence in elderly and give appropriate treatment. Appropriate treatment of urinary incontinence among elderly will improve their self esteem and lead to better quality of life.

Conclusion This study showed, community elderly suffer more from urinary incontinence than elderly living in pondok and old folks home.

References Aggazzotti, G., Pesce, F., Grassi, D., Fantuzzi, G., Righi, E., De Vita, D., Santacroce, S. & Artibani, W. (2000). Prevalence of urinary incontinence among institutionalized patients: a cross-sectional epidemiologic study in a midsized city in northern Italy. Urology, 56(2), 245-249 Sidik, S. M., Rampal, L. & Afifi, M. (2004). Physical and mental health problems of the elderly in a rural community of Sepang, Selangor. The Malaysian Journal of Medical Sciences: MJMS, 11(1), 52. (http://www.who.int/ageing/publications/Age-Friendly-PHC-Centre) Xu, D. & Kane, R. L. (2013). Effect of Urinary Incontinence on Older Nursing Home Residents’ Self‐Reported Quality of Life. Journal of the American Geriatrics Society, 61(9), 1473-1481.

Thank you Dr. Rohayu Hami rohayuhami@usm.my