BackgroundUrinary incontinence (UI) is a frequent, but neglected
geriatric syndrome, particularly in vulnerable older patients.
Optimizing screening procedures is necessary.ObjectiveTo compare the
clinometric performances of the continence item of the Katz's ADL scale
and the ICIQ-UI-sf for the screening of UI in vulnerable aged
patients.MethodsA prospective study was conducted in the acute care for
elders (ACE) unit of an academic centre. Two independent nurses screened
all patients with spontaneous urination for UI with Katz's ADL item and
ICIQ-UI-sf upon the hospital admission. The diagnosis of UI resulted
from an interdisciplinary conciliating meeting for urinary functional
disorders (TOFU), gathering geriatricians and neuro-urologists and was
considered as reference.Results294 consecutive patients (mean age
86.26.5years; 76.5% female) admitted to the ACE unit were screened; 169
were incontinent (57.5%) according to TOFU. The Katz's ADL item
identified 106 incontinent patients with 20 false positives; 83
incontinent patients were not identified. If the sensitivity and
specificity of the ICIQ-UI-sf were 100.0%, they were, respectively, 50.9
and 84.0% for the Katz's ADL item. Positive and negative predictive
values were 100.0% for ICIQ-UI-sf; 81.1 and 55.9% for ADL,
respectively.Conclusionp id=Par5This study validates the ICIQ-UI-sf as a
simple and effective screening tool for UI in vulnerable and complex
hospitalized aged patients. It also demonstrates that the continence
item of the Katz's ADL scale is not sensitive enough for UI screening in
this population.