Incontinência urinária é associada com o declínio do desempenho físico em mulheres idosas residentes na comunidade: resultados do International Mobility in Aging Study (IMIAS)
Bibliographic record
Abstract
Introduction: With aging, women present worse physical performance when compared to men of similar ages, suggesting that there are factors related to sex or gender, such as variables of reproductive history that may explain these differences. High parity and early maternal age are related to the occurrence of urogynecological disorders, such as Urinary Incontinence (UI), and it is also known that women who had many children and / or were mothers in adolescence have worse health conditions in old ages, including worse physical performance. Hypothesize that women who report UI have worse physical performance and a more pronounced reduction of UI over the years. However, there is a gap in the literature to prove these hypotheses. Objectives: To evaluate if there is a relationship between urinary incontinence and physical performance in older women from five sites with different socioeconomic conditions and to evaluate the influence of urinary incontinence on the change in physical performance over a two-year period. Methodology: This is a longitudinal observational study derived from the International Mobility in Aging Study (IMIAS), conducted in Saint-Hyacinthe (Quebec, Canada), Kingston (Ontario, Canada), Manizales (Colombia), Tirana (Albania) and Natal (Brazil). In this study, approximately 200 older women (65 and 74 years old) from each locality, residents on community, were evaluated in the years of 2012, 2014 and 2016. The present study presents data collected in 2014 and 2016. For the evaluation, socioeconomic data, anthropometric measures and reproductive history were collected. Physical performance was assessed using the Short Physical Performance Battery (SPPB) following a standardized protocol that measures balance, gait and lower limbs strength. The SPPB final score is a sum of the points of each test, ranging from 0 to 12 points (4 points for each test). Urinary incontinence was assessed by self-report of episodes of involuntary loss of urine in the last week, classified as "none in the past 7 days" and "some in the last 7 days". The cross-sectional relationship between UI and SPPB was assessed by multiple linear regression analysis. The evaluation of the longitudinal effect of UI on the SPPB score over 2 years was evaluated by analysis of mixed linear models. In both analyzes, covariables were considered: age, study site, education, income sufficiency, and parity. Results: The sample was composed by 915 women with mean age of 71.2 (± 2.88). The prevalence of urinary incontinence ranged from 11.4% (Natal) and 30.7% (Kingston). The women who reported some loss of urine presented a significantly lower SPPB mean than the others, even in the fully adjusted models (β =-0.469, p= 0.009). In addition, they show a significantly greater reduction in SPPB scores over two years than women who did not report UI (β =-0.533, p=0.001). Conclusion: UI is associated with worse results in SPPB and negatively influences physical performance over two years, since women with UI have a more pronounced decline in physical performance in this period. These findings serve as the basis for the planning and implementation of early interventions to improve the aging profile of women and the quality of life of this population.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.005 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".