HHS Public Access Author manuscript Author Manuscript
Am J Obstet Gynecol. Author manuscript; available in PMC 2016 May 01. Published in final edited form as: Am J Obstet Gynecol. 2016 May ; 214(5): 613.e1–613.e7. doi:10.1016/j.ajog.2015.11.038.
Functional Status in Older Women Diagnosed with Pelvic Organ Prolapse Tatiana V.D. SANSES, MD1, Nicholas K. SCHILTZ, PhD2, Bruna M. COURI, MD3, Sangeeta T. MAHAJAN, MD2,4, Holly E. RICHTER, MD, PhD5, David F. WARNER, PhD6, Jack GURALNIK, MD, PhD1, and Siran M. KOROUKIAN, PhD2 1University
Author Manuscript
2Case
of Maryland School of Medicine, Baltimore, MD, USA
Western Reserve University, Cleveland, Ohio, USA
3Cleveland
Clinic, Cleveland, OH, USA
4University
of Hospitals Case Medical Center, Cleveland, OH, USA
5University
of Alabama at Birmingham School of Medicine, Birmingham, AL
6University
of Nebraska–Lincoln, Lincoln, NE, USA
Abstract
Author Manuscript
Background—Functional status plays an important role in the comprehensive characterization of older adults. Functional limitations are associated with an increased risk of adverse treatment outcomes, but there is limited data on the prevalence of functional limitations in older women with pelvic floor disorders. Objective—The aim of the study was to describe the prevalence of functional limitations based on health status in older women with pelvic organ prolapse.
Corresponding author: Tatiana V. Sanses, M. D., Assistant Professor of Obstetrics & Gynecology, Female Pelvic Medicine & Reconstructive Surgery, University of Maryland School of Medicine, 22 S Greene St UMH – S3AX-24, Baltimore, MD 21201, (Tel) 410-328-0729; (Fax) 410-328-1582, [email protected]. Paper Presentation: 2014 Scientific Meeting, the American Urogynecologic Society (AUGS) and the International Urogynecologic Association (IUGA), Washington DC, July 22–26, 2014
Author Manuscript
Disclosures: Dr. Sanses is supported by K12 HD43489 Building Interdisciplinary Research Careers in Women’s Health, National Institute of Child Health and Human Development Dr. Schiltz is supported by KL2TR000440 Clinical and Translational Science Collaborative of Cleveland from the National Center for Advancing Translational Sciences (NCATS) component of the National Institutes of Health. Dr. Couri has no conflict of interest to report Dr. Mahajan is an Allergan, Inc. consultant and has a research grant; Pfizer, Inc. Consultant; Uptodate royalties. Dr. Richter is a Pelvalon consultant and has research grant; Kimberly Clarke, consultant; Uptodate, royalties. Dr. Warner is supported by a grant from the Agency for Healthcare Research and Quality (R21 HS023113). Dr. Guralnik is supported by a grant from the National Institute of Aging (R01 AG048069) Dr. Koroukian is supported a grant from the Agency for Healthcare Research and Quality (R21 HS023113) and by UL1TR000439 Clinical and Translational Science Collaborative of Cleveland from the National Center for Advancing Translational Sciences (NCATS) component of the National Institutes of Health. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
SANSES et al.
Page 2
Author Manuscript
Study Design—This pooled, cross-sectional study utilized data from the linked Health and Retirement Study and Medicare files between 1992 and 2008. The analysis included 890 women ≥65 years with pelvic organ prolapse. We assessed self-reported functional status, categorized in strength, upper and lower body mobility, activities of daily living, and instrumental activities of daily living domains. Functional limitations were evaluated and stratified by respondents selfreported general health status. Descriptive statistics were used to compare categorical and continuous variables, and logistic regression was used to measure differences in the odds of functional limitation by increasing age.
Author Manuscript
Results—The prevalence of functional limitations was 76.2% in strength, 44.9% in upper and 65.8% in lower body mobility, 4.5% in activities of daily living and 13.6% in instrumental activities of daily living. Limitations were more prevalent in women with poor or fair health status than in women with good health status, including 91.5% vs 69.9% in strength, 72.9% vs 33.5% in upper and 88.0% vs 56.8% in lower body mobility, 11.6% vs 0.9% in activities of daily living, and 30.6% vs 6.7% in instrumental activities of daily living, all p
Am J Obstet Gynecol. Author manuscript; available in PMC 2016 May 01. Published in final edited form as: Am J Obstet Gynecol. 2016 May ; 214(5): 613.e1–613.e7. doi:10.1016/j.ajog.2015.11.038.
Functional Status in Older Women Diagnosed with Pelvic Organ Prolapse Tatiana V.D. SANSES, MD1, Nicholas K. SCHILTZ, PhD2, Bruna M. COURI, MD3, Sangeeta T. MAHAJAN, MD2,4, Holly E. RICHTER, MD, PhD5, David F. WARNER, PhD6, Jack GURALNIK, MD, PhD1, and Siran M. KOROUKIAN, PhD2 1University
Author Manuscript
2Case
of Maryland School of Medicine, Baltimore, MD, USA
Western Reserve University, Cleveland, Ohio, USA
3Cleveland
Clinic, Cleveland, OH, USA
4University
of Hospitals Case Medical Center, Cleveland, OH, USA
5University
of Alabama at Birmingham School of Medicine, Birmingham, AL
6University
of Nebraska–Lincoln, Lincoln, NE, USA
Abstract
Author Manuscript
Background—Functional status plays an important role in the comprehensive characterization of older adults. Functional limitations are associated with an increased risk of adverse treatment outcomes, but there is limited data on the prevalence of functional limitations in older women with pelvic floor disorders. Objective—The aim of the study was to describe the prevalence of functional limitations based on health status in older women with pelvic organ prolapse.
Corresponding author: Tatiana V. Sanses, M. D., Assistant Professor of Obstetrics & Gynecology, Female Pelvic Medicine & Reconstructive Surgery, University of Maryland School of Medicine, 22 S Greene St UMH – S3AX-24, Baltimore, MD 21201, (Tel) 410-328-0729; (Fax) 410-328-1582, [email protected]. Paper Presentation: 2014 Scientific Meeting, the American Urogynecologic Society (AUGS) and the International Urogynecologic Association (IUGA), Washington DC, July 22–26, 2014
Author Manuscript
Disclosures: Dr. Sanses is supported by K12 HD43489 Building Interdisciplinary Research Careers in Women’s Health, National Institute of Child Health and Human Development Dr. Schiltz is supported by KL2TR000440 Clinical and Translational Science Collaborative of Cleveland from the National Center for Advancing Translational Sciences (NCATS) component of the National Institutes of Health. Dr. Couri has no conflict of interest to report Dr. Mahajan is an Allergan, Inc. consultant and has a research grant; Pfizer, Inc. Consultant; Uptodate royalties. Dr. Richter is a Pelvalon consultant and has research grant; Kimberly Clarke, consultant; Uptodate, royalties. Dr. Warner is supported by a grant from the Agency for Healthcare Research and Quality (R21 HS023113). Dr. Guralnik is supported by a grant from the National Institute of Aging (R01 AG048069) Dr. Koroukian is supported a grant from the Agency for Healthcare Research and Quality (R21 HS023113) and by UL1TR000439 Clinical and Translational Science Collaborative of Cleveland from the National Center for Advancing Translational Sciences (NCATS) component of the National Institutes of Health. Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
SANSES et al.
Page 2
Author Manuscript
Study Design—This pooled, cross-sectional study utilized data from the linked Health and Retirement Study and Medicare files between 1992 and 2008. The analysis included 890 women ≥65 years with pelvic organ prolapse. We assessed self-reported functional status, categorized in strength, upper and lower body mobility, activities of daily living, and instrumental activities of daily living domains. Functional limitations were evaluated and stratified by respondents selfreported general health status. Descriptive statistics were used to compare categorical and continuous variables, and logistic regression was used to measure differences in the odds of functional limitation by increasing age.
Author Manuscript
Results—The prevalence of functional limitations was 76.2% in strength, 44.9% in upper and 65.8% in lower body mobility, 4.5% in activities of daily living and 13.6% in instrumental activities of daily living. Limitations were more prevalent in women with poor or fair health status than in women with good health status, including 91.5% vs 69.9% in strength, 72.9% vs 33.5% in upper and 88.0% vs 56.8% in lower body mobility, 11.6% vs 0.9% in activities of daily living, and 30.6% vs 6.7% in instrumental activities of daily living, all p
