LAUSR

available at http://www.ncbi.nlm.nih.gov/pubmed/29439853 Editorial Comment: Urinary incontinence (UI) is among the most common genitourinary conditions in older adults. Within the field of clinical geriatrics this condition is viewed as a syndrome as well as a diagnosis. Geriatric syndromes are complex conditions that are multifactorial in origin and involve a myriad of interactions between physical, cognitive and psychosocial factors. This study examined the relationships between underlying frailty and UI in a cohort of 210 geriatric patients (mean SD age 89.4 4.6 years) who were hospitalized on a geriatric medicine unit at a large academic medical center. Of the patients 69.5% were female and 50% were frail. Baseline prevalence of UI was 64.8% in those who were frail vs 30.5% in those who were not frail (p <0.001). At discharge from acute care hospitalization new onset urinary incontinence was present in 24.3% of frail vs 9.6% of nonfrail patients (p <0.001). This trend continued even at 6 and 12 months following discharge. Baseline and incident UI were also predictive of increased risk of death at 6 and 12 months, even after adjusting for multiple other risk factors. The authors argue that more attention should be given to identifying and treating UI in elderly patients, particularly frail older adults, at acute hospitalization and before discharge. It will be interesting to see if acute interventions in this setting can help to reduce or resolve UI, if those clinical improvements can be sustained and if they indeed influence subsequent outcomes, including mortality, in elderly patients. Tomas L. Griebling, MD, MPH GERIATRICS 643 Copyright © 2019 American Urological Association Education and Research, Inc. Unauthorized reproduction of this article is prohibited.