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Prevalence of cognitive impairment in older women with pelvic floor disorders
Cynelle Murray Kunkle1,2, Melinda G Abernethy3, Lily R Van Tongeren3
1Division of Urogynecology, Department of Gynecology and Obstetrics, Johns Hopkins School of Medicine, Baltimore, MD, USA. cynellekunkle@gmail.com.
Introduction And Hypothesis:
This study aimed to determine the prevalence of mild cognitive impairment (MCI) and early dementia among women >55 years seeking care for pelvic floor disorders (PFDs) and to describe the impact of cognitive impairment on condition-specific quality of life (QoL). We hypothesized that the prevalence of MCI would be at least 15% among this population.
Methods:
This was a cross-sectional study of English-speaking women >55 years presenting for evaluation of PFDs. We assessed baseline demographics and administered the Short Test of Mental Status (STMS) to screen for cognitive impairment. We predicted a sample of 196 would be needed for a precision of ±5% of the estimated sample prevalence in participants with PFDs. Chi-square tests were used to compare categorical variables and Student's t tests and analysis of variance (ANOVA) for continuous variables. Multivariate regression analysis was used to assess for any independent association with cognitive impairment and condition-specific QoL.
Results:
Between July 2013 and July 2014, 211 participants were enrolled. The prevalence of MCI and early dementia were 15% [95% confidence interval (CI) 10.9-20.6; n = 32)] and 17% (95% CI 11.9-22.1; n = 36], respectively. Patients with MCI and early dementia had higher Patient Heath Questionnaire scores indicating greater depressive symptoms (p = 0.006) and higher overall Pelvic Floor Impact Questionnaire scores indicating worse condition-specific QoL (p = 0.008).
Conclusion:
MCI and early dementia were prevalent in our population seeking care for PFDs. Women with cognitive impairment experienced worse condition-specific QoL.