The aim of this cross-sectional observational study is to examine the independent associations of urinary incontinence severity and post-void residual urine volume with frailty and other geriatric outcomes in older adults presenting to a urology outpatient clinic with urinary incontinence.
Age 65 years or older,
Presence of involuntary urinary leakage according to the International Continence Society definition,
At least one urinary leakage episode during the previous four weeks and an ICIQ-UI SF score of ≥1,
General health status adequate to tolerate the outpatient assessment protocol,
Acute urinary tract infection or acute lower urinary tract symptoms,
History of major pelvic or orthopedic surgery within the previous six months,
Acute musculoskeletal condition that may affect performance during the assessments,
Neurological disease causing severe mobility limitations, including Parkinson's disease or stroke,
The study population will consist of women and men aged 65 years or older presenting to the Urology Outpatient Clinic of Karabuk Training and Research Hospital with urinary incontinence. Individuals who meet the eligibility criteria, are able to mobilize independently, and provide written informed consent will be enrolled consecutively during the study period. All participants will have experienced at least one urinary leakage episode during the previous four weeks and will have an ICIQ-UI SF score of ≥1. No healthy control group will be included.
Case-only
Cross-sectional
Not listed
Frailty Level Assessed Using the FRAIL Scale
The primary outcome is frailty level, assessed using the five-item FRAIL Scale. The total score ranges from 0 to 5, with higher scores indicating greater frailty. Participants will be classified as robust (0 points), prefrail (1-2 points), or frail (≥3 points). The primary exposures are urinary incontinence severity, assessed using the ICIQ-UI SF total score (range: 0-21), and post-void residual urine volume, recorded in milliliters as the mean of two consecutive bladder scanner measurements performed within 10 minutes after voiding. The independent associations of ICIQ-UI SF score and post-void residual urine volume with frailty level will be examined in the same multivariable regression model after adjustment for prespecified covariates.
Physical Performance Assessed Using the Short Physical Performance Battery
Physical performance will be assessed using the Short Physical Performance Battery (SPPB), comprising standing balance, usual-paced walking, and five-repetition chair-rise tests. Each component is scored from 0 to 4, resulting in a total score ranging from 0 to 12. Higher scores indicate better physical performance. A total score of ≤8 will be considered indicative of low physical performance.
Functional Mobility Assessed Using the Timed Up and Go Test
Functional mobility will be assessed using the Timed Up and Go Test (TUG). Participants will stand up from a chair, walk three meters, turn, walk back to the chair, and sit down. Completion time will be recorded in seconds, with longer times indicating poorer functional mobility.
Motor-Cognitive Mobility Assessed Using the Dual-Task Timed Up and Go Test
Motor-cognitive mobility will be assessed using the Dual-Task Timed Up and Go Test (DT-TUG). Participants will complete the TUG while simultaneously performing serial subtraction by threes from 100. Completion time will be recorded in seconds, with longer times indicating poorer motor-cognitive mobility performance.
Handgrip Strength Measured Using a Hand Dynamometer
Handgrip strength will be measured in the dominant hand using a BASELINE hand dynamometer. Three trials will be performed, and the highest value, recorded in kilograms, will be used in the analysis. Values below 27 kg in men and below 16 kg in women will be classified as low muscle strength.
Sarcopenia Risk Assessed Using the SARC-F
Sarcopenia risk will be assessed using the five-item SARC-F questionnaire. Each item is scored from 0 to 2, resulting in a total score ranging from 0 to 10. Higher scores indicate greater sarcopenia risk, and a total score of ≥4 will be considered indicative of sarcopenia risk.
Appendicular Skeletal Muscle Mass Assessed Using Bioelectrical Impedance Analysis
Appendicular skeletal muscle mass will be measured using a Tanita multi-frequency segmental body composition analyzer. Appendicular skeletal muscle mass will be recorded in kilograms, and the appendicular skeletal muscle mass index will be calculated as appendicular skeletal muscle mass divided by height squared (kg/m²). Values below 7.0 kg/m² in men and below 5.5 kg/m² in women will be considered indicative of low muscle mass.
Calf Circumference
Calf circumference will be measured using a non-elastic tape at the widest part of both calves. The highest measurement will be recorded in centimeters. Values below 34 cm in men and below 33 cm in women will be classified as low calf circumference.
Nutritional Status Assessed Using the Mini Nutritional Assessment-Short Form
Nutritional status will be assessed using the six-item Mini Nutritional Assessment-Short Form (MNA-SF). The total score ranges from 0 to 14. Participants will be classified as having normal nutritional status (12-14 points), being at risk of malnutrition (8-11 points), or having malnutrition (0-7 points).
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MERT UYSAL
Lead sponsor
Karabuk University
Sponsor institution
Karabuk Training and Research Hospital
Collaborator
Karabuk University
Collaborator
Abant Izzet Baysal University
Collaborator
