Urinary incontinence in Japanese women with chronic obstructive pulmonary disease: review

The relationship between urinary incontinence and chronic obstructive pulmonary disease (COPD) among Japanese women is reviewed. The prevalence of COPD is increasing because of the aging population and the high rate of cigarette consumption. The prevalence of COPD in Japan was 16.4% for males and 5% for females aged 40 years and above in 2000. COPD is a progressive disease, which can have periods of relative stability but readily regresses. Its characteristic symptoms include cough, sputum production, dysponea and frequently urinary incontinence. The persistent cough of COPD increases intra-abdominal pressure and results in increased rates of urinary incontinence especially for female patients. The prevalence of urinary incontinence among Japanese women with chronic lung disease varied between 30.4% and 68%, which was comparatively higher than those of the general population (25-56.9%) and outpatient clients attending gynaecology clinics (27-31%). However, there is no published report specifically on the prevalence of urinary incontinence for Japanese women with COPD. As COPD is one of the causes of urinary incontinence, the obvious prevention strategy is tobacco control and early detection using screening test. Urinary incontinence should be identified and dealt with in order to improve the quality of life for COPD patients

Caffeine intake and the risk of chronic obstructive pulmonary disease in Japanese adults

Background: To investigate the association between caffeine intake and the risk of developing chronic obstructive pulmonary disease (COPD) among Japanese older adults, a case–control study was conducted in central Japan. Methods: A total of 277 patients with COPD aged 50 to 75 years were referred by respiratory physicians, while 340 controls were recruited from the community. All participants had their disease status confirmed by spirometry. Information on habitual caffeine intake, demographic, and lifestyle characteristics was obtained by face-to-face interview using a validated questionnaire. Results: The COPD patients drank more coffee and had a higher mean caffeine intake (311.3, SD 176.2mg/day) than the control group (278.4, SD 188.1 mg/day), p = 0.03. Relative to nondrinkers, the risk of COPD apparently increased for those drinking at least two cups of coffee daily (adjusted odds ratio 1.58, 95% confidence interval [CI] 0.93 to 2.71). Similarly, total caffeine intake was associated with the prevalence of COPD—the adjusted odds ratio being 1.30 (95% CI 1.09 to 2.12) for consuming over 312mg/day when compared to a low intake of less than 184mg/day. Conclusions: The epidemiological evidence suggested a positive association between caffeine intake and the development of COPD in Japanese adults. Further study of the effect of caffeine on lung function and the risk of COPD should be undertaken

Is Caffeine Intake Associated With Urinary Incontinence in Japanese Adults?

Objectives: To investigate whether caffeine intake is associated with urinary incontinence (UI) among Japanese adults. Methods: A total of 683 men and 298 women aged 40 to 75 years were recruited from the community in middle and southern Japan. A validated food frequency questionnaire was administered face-to-face to obtain information on dietary intake and habitual beverage consumption. Urinary incontinence status was ascertained using the International Consultation on Incontinence Questionnaire-Short Form. Results: Mean daily caffeine intake was found to be similar between incontinent subjects (men 120 mg, women 94 mg) and others without the condition (men 106 mg, women 103 mg), p=0.33 for men and p=0.44 for women. The slight increases in risk of UI at the highest level of caffeine intake were not significant after adjusting for confounding factors. The adjusted odds ratios (95% confidence interval) were 1.36 (0.65 to 2.88) and 1.12 (0.57 to 2.22) for men and women, respectively. Conclusions: No association was evident between caffeine intake and UI in middle-aged and older Japanese adults. Further studies are required to confirm the effect of caffeine in the prevention of UI

Breathlessness is associated with urinary incontinence in men: A community-based study

<p>Abstract</p> <p>Background</p> <p>Urinary incontinence (UI) is a distressing problem for older people. To investigate the relationship between UI and respiratory symptoms among middle-aged and older men, a community-based study was conducted in Japan.</p> <p>Methods</p> <p>A convenience sample of 668 community-dwelling men aged 40 years or above was recruited from middle and southern Japan. The International Consultation on Incontinence Questionnaire-Short Form, the Medical Research Council's dyspnoea scale and the Australian Lung Foundation's Feeling Short of Breath scale, were administered by face-to-face interviews to ascertain their UI status and respiratory symptoms.</p> <p>Results</p> <p>The overall prevalence of UI was 7.6%, with urge-type leakage (59%) being most common among the 51 incontinent men. The presence of respiratory symptoms was significantly higher among incontinent men than those without the condition, especially for breathlessness (45% versus 30%, <it>p </it>= 0.025). The odds of UI for breathlessness was 2.11 (95% confidence interval 1.10-4.06) after accounting for age, body mass index, smoking and alcohol drinking status of each individual.</p> <p>Conclusions</p> <p>The findings suggested a significant association between UI and breathlessness in middle-aged and older men.</p

Alcohol consumption, smoking and lifestyle characteristics for Japanese patients with chronic obstructive pulmonary disease

This thesis investigated lifestyle characteristics including cigarette smoking, alcohol consumption, dietary supplements intake, physical activity, and urinary incontinence status for Japanese patients with chronic obstructive pulmonary disease (COPD). Field studies were conducted in the middle of Japan. The study was conducted using a cross-sectional survey and all patients were recruited from the outpatient departments of six hospitals in three districts/prefectures, namely, Aichi, Gifu, and Kyoto. Three hundred referred COPD patients diagnosed by respiratory physicians were recruited in 2006. Inclusion criteria were (i) aged between 50 and 75 years; and (ii) had COPD as the primary functionally limiting illness which was diagnosed within the past four years. Diagnosis of COPD was confirmed by spirometry with FEV1/FVC < 70%, where FEV1 = forced expiratory volume in one second and FVC = forced vital capacity. A structured questionnaire was administered to collect information on lifestyle characteristics. All interviews, averaging 40 minutes, took place in the hospital outpatient departments. Clinical characteristics, height, weight and presence of any co-morbidity (e.g. diabetes, hypertension, cardiovascular disease), were retrieved from medical records.A total of 278 eligible participants (244 men and 34 women) were available for analysis. The majority were men (88%) with mean age 66.5 (SD 6.7) years and mean body mass index (BMI) 21.9 (SD 3.6). Most of them were married (84%), had high school or below education (80%) and retired (55%). In relation to cigarette smoking, 62 (53 male and 9 female) participants (22.5%) were current smokers of whom the great majority (89%) smoked daily. Only six (2.1%) participants were never smokers. The prevalence of smoking by time from diagnosis was: 24.5% (< 1 year), 20.6% (1-2 years), and 18.9% (2-4 years). Continuous smoking was inversely associated with age (odds ratio (OR) = 0.94, 95% confidence interval (CI) 0.90-0.98), BMI (OR = 0.88, 95% CI 0.80-0.97) and disease severity vii (OR = 0.29, 95% CI 0.12-0.74 for severe COPD and OR = 0.29, 95% CI 0.09-0.92 for very severe COPD). For alcohol consumption, 158 (150 male and 8 female) patients (56.8%) drank alcohol regularly on at least a monthly basis, the majority of them (73.4%) being daily drinkers. Beer was the most preferred alcoholic beverage drank (30.9%). Alcohol intake appeared to be positively associated with the habit of adding soy sauce to foods, whereas dyspnoea of patients posed significant limitations for them to drink alcoholic beverages.Also, female patients tended to have lower alcohol consumption levels than male patients. Regarding dietary supplements, 117 (101 male and 16 female) participants (42.1%) were dietary supplement users, but the prevalence for female patients (47.1%) was higher than male patients (41.4%). Younger patients (≤ 60 years) and those with severe COPD had relatively low proportion of users (27.3% and 28.9%, respectively). Dietary supplementation was found to be affected by age (p = 0.04), COPD severity (p = 0.03) and presence of co-morbidity (p = 0.03). Older patients over 60 years were more likely to take dietary supplements (OR = 2.44, 95% CI 1.03-5.80), whereas severe COPD patients (OR = 0.41, 95% CI 0.18-0.95) and those with a co-morbidity (OR = 0.54, 95% CI 0.32-0.94) tended not to use. With respect to physical activity of COPD patients, 198 (175 male and 23 female) of them (77%) participated in physical activities on at least weekly basis, but only 22% and 4% engaged in moderate and vigorous activities, respectively. Over 2/3 of them walked at least weekly. Regression analysis showed that perceived life-long physical activity involvement appeared to be positively associated with total physical activity, whereas patients with very severe COPD tended to have significantly lower total physical activity levels.Besides COPD severity, both age and smoking exhibited a negative impact on walking. It is evident that walking activities decreased among very severe patients, current smokers and those in advanced age. The prevalence of urinary incontinence was 12.6% (10% for men and 32% for women). The most common occurrence of urine loss was before reaching the toilet (54%) followed by coughing/sneezing (23%). While urge incontinence was reported viii by 63% of male incontinent patients, 82% of female incontinent patients experienced stress incontinence. Incontinence was more likely among female patients (OR = 8.7, 95% CI 3.2-23.4) and older patients over 70 years (OR = 2.3, 95% CI 1.0-5.2). COPD severity was also found to be a significant factor (p = 0.007), with very severe patients at slightly higher risk of urinary incontinence (OR = 1.1, 95% CI 0.3-3.5) than mild COPD patients, though the relationship appeared not to be linear across the severity classifications. It is alarming to find mild and moderate COPD patients continue to smoke. The implementation of a co-ordinated tobacco control program immediately post diagnosis is needed for the effective pulmonary rehabilitation of COPD patients. The high alcohol consumption by COPD patients is also alarming. Alcohol control programs targeting male patients should be promoted during pulmonary rehabilitation in order to minimise the harm due to excessive drinking. Dietary supplements are popular for patients with COPD especially among older patients.The findings are important to clinical trials and experimental interventions advocating nutritional supplementation therapy for pulmonary rehabilitation. Patients with COPD had lower physical activity levels than the general elderly population. Older patients with very severe COPD and those who currently smoke should be targeted for intervention and encouraged to increase their participation in physical activity so as to maintain their health and well being. The high prevalence yet underreporting of urinary incontinence suggested that education and regular assessment are needed after COPD diagnosis. Appropriate exercise and treatment tailored for the specific type of incontinence incurred should be incorporated within the rehabilitation program of COPD patients. To maintain a healthy lifestyle and to achieve optimal outcomes during the pulmonary rehabilitation of COPD patients, the identified factors should be taken into consideration and health awareness programs should be promoted in conjunction with respiratory physicians and allied health professionals

Vegetable Consumption by Older Adults in Japan

Background: The importance and health benefits of vegetables are well known, while the nutritional requirements of older adults are different from those of younger adults. Objective: This study investigated vegetable consumption by gender and age groups among Japanese older adults. Method: A total of 558 eligible participants (341 men and 217 women) aged 55 to 75 years were recruited from 10 districts/prefectures in middle and southern Japan. Information on habitual vegetable consumption was obtained by face-to-face interviews using a validated and reliable food frequency questionnaire. Results: Women were found to consume more vegetables (mean 274, SD 166 g/day) than men (mean 207, SD 135 g/day) overall (p < 0.001) and across age groups 55-59, 60-64, 65-69 and 70-75 years. However, the intake levels of both genders did not vary significantly between age groups. The Japanese government has recommended an intake level of 350g or more per day for individuals. It is alarming that 83% of participants did not eat an adequate amount of vegetables. Conclusion: Japanese older adults especially men should be encouraged to increase their vegetable consumption in order to maintain their health and well-being

Preventive factors for urinary incontinence

Urinary incontinence (UI) is a distressing condition for middle aged and older adults. The prevalence of UI varies substantially worldwide, depending on the definition adopted, the population being studied, and the instrument used for assessing leakage. Established risk factors are the female gender, obesity, advanced age and cigarette smoking. The main treatments include pharmacological prescriptions, conservative therapies (such as pelvic floor muscle exercise, biofeedback, electrical stimulation), and surgery. This chapter reviews the epidemiological evidence on emerging factors which may protect against the disease. Increasing green tea consumption appears to reduce the prevalence of UI among women. Low alcohol intake particularly beer is inversely associated with male UI, whereas the corresponding relationship for women remains inconsistent. Moreover, physical activity in daily life may mediate against the development of UI. Further research is required to understand the biological mechanisms concerning these factors, especially by gender and incontinence subtype, in order to prevent this bothersome condition for the aging population

Fluid Intake and Risk of Male Urinary Incontinence

Objective: To investigate whether fluid intake is associated with urinary incontinence (UI) in men. Methods: A total of 700 men from 40 to 75 years old were recruited from the community in central and southern Japan. A validated food frequency questionnaire was administered face-to-face to obtain information on habitual beverage consumption. UI status was ascertained using the International Consultation on Incontinence Questionnaire-Short Form. Logistic regression analysis was conducted to assess the relationship between total fluid intake and the prevalence of UI. Results: Among the 683 eligible participants (mean age 62 years), 49 men (7.2%) experienced urine leakage for the past 2.6 (standard deviation [SD] 1.9) years. The mean daily fluid intake was slightly higher (p=0.08) among incontinent men (1766, SD 1171 mL) than those without the condition (1460, SD 918 mL). However, the increases in risk of UI at higher levels of fluid intake were not significant after accounting for age and other confounding factors. Conclusion: Little association was evident between fluid intake and UI in middle-aged and older Japanese men