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Frailty, cognitive impairment, and functional disability in older women with female pelvic floor dysfunction

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Abstract

Introduction and hypothesis

There is a growing body of evidence demonstrating frailty as an important predictor of surgical outcomes in older adults undergoing major surgeries. The age-related onset of many symptoms of female pelvic floor dysfunction (PFD) in women suggests that many women seeking treatment for PFD may also have a high prevalence of frailty, which could potentially impact the risks and benefits of surgical treatment options. Our primary objective was to determine the prevalence of frailty, cognitive impairment, and functional disability in older women seeking treatment for PFD.

Methods

We conducted a cross-sectional study with prospective recruitment between September 2011 and September 2012. Women, age 65 years and older, were recruited at the conclusion of their new patient consultation for PFD at a tertiary center. A comprehensive geriatric screening including frailty measurements (Fried Frailty Index), cognitive screening (Saint Louis University Mental Status score), and functional status evaluation for activities of daily living (Katz ADL score) was conducted.

Results

Sixteen percent (n/N = 25/150) of women were categorized as frail according to the Fried Frailty Index score. After adjusting for education level, 21.3 % of women (n/N = 32/150) screened positive for dementia and 46 (30.7 %) reported functional difficulty or dependence in performing at least one Katz ADL. Sixty-nine women (46.0 %) chose surgical options for treatment of their PFD at the conclusion of their new patient visit with their physician.

Conclusions

Frailty, cognitive impairment, and functional disability are common in older women seeking treatment for PFD.

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Acknowledgments

This research was supported in part by a grant from the American Urogynecologic Society (AUGS) Foundation. Dr. Erekson was supported through a grant from the Claude D. Pepper Older Americans Independence Center at Yale University School of Medicine (#P30AG021342 NIH/NIA). The funding agreement ensured the authors independence in designing the study, interpreting the data, and writing and publishing the article.

Conflicts of interest

None.

Author information

Authors and Affiliations

  1. Department of Obstetrics and Gynecology, Geisel School of Medicine at Dartmouth, Hanover, NH, USA

    Elisabeth A. Erekson & Kris Strohbehn

  2. The Dartmouth Institute for Health Policy and Clinical Practice, Geisel School of Medicine at Dartmouth, Hanover, NH, USA

    Elisabeth A. Erekson & Julie P. W. Bynum

  3. Department of Medicine, Yale University School of Medicine, New Haven, CT, USA

    Terri R. Fried & Deanna K. Martin

  4. Clinical Epidemiology Research Center, VA Connecticut Healthcare System, West Haven, CT, USA

    Terri R. Fried

  5. Department of Obstetrics, Gynecology, and Reproductive Sciences, Yale University School of Medicine, New Haven, CT, USA

    Thomas J. Rutherford

  6. Division of Urogynecology, Geisel School of Medicine at Dartmouth, 1 Medical Center Drive, Lebanon, NH, 03756, USA

    Elisabeth A. Erekson

Authors
  1. Elisabeth A. Erekson
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  2. Terri R. Fried
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Correspondence to Elisabeth A. Erekson.

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Erekson, E.A., Fried, T.R., Martin, D.K. et al. Frailty, cognitive impairment, and functional disability in older women with female pelvic floor dysfunction. Int Urogynecol J 26, 823–830 (2015). https://doi.org/10.1007/s00192-014-2596-2

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  • DOI: https://doi.org/10.1007/s00192-014-2596-2

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