Urinary incontinence in the elderly is a major problem with significant medical, psychological, and social consequences. Previous research on urge incontinence, a common form of incontinence, has demonstrated that behavioral interventions and drug treatments are effective for many individuals. However, it is clear that no one method has been 100% effective and all methods have disadvantages. This project will be a prospective, randomized trial comparing the effects of behavioral training, drug therapy (oxybutynin) and placebo on urge incontinence in ambulatory, community-dwelling women aged 55 years and older. Although the two treatments have been studied individually, their effects have never been compared. Approximately 390 women will be evaluated for participation with the expectation that 195 will complete the protocol. Stratified and blocked randomization procedures will be used to assign subjects to 4 sessions (8 weeks) of biofeedback-assisted behavioral training, 4 sessions (8 weeks) of treatment with oxybutynin, or 4 sessions (8 weeks) of placebo. The study will also evaluate the combined effects of the two interventions and characterize patients on clinical variables that may influence outcome. The candidate was a fellow at the Gerontology Research Center, N.I.A. or six years during which time she focused her research on the development and testing of behavioral methods for the treatment of urinary and fecal incontinence. In her new position as Director of Research at the Benedum Geriatric Center at the University of Pittsburgh, Department of Medicine, she plans to extend her research on incontinence. Her short term goals are to further evaluate and improve treatment methods for incontinence. Her long range career goals involve continued investigations of urinary incontinence in collaboration with faculty and fellows in geriatrics, nursing, neurology, urology, rehabilitation and gynecology. She hopes to establish herself as an expert in the field of incontinence, and to expand her research to other problem areas in behavioral geriatrics.

Agency
National Institute of Health (NIH)
Institute
National Institute on Aging (NIA)
Type
Modified Research Career Development Award (K04)
Project #
5K04AG000431-03
Application #
3070576
Study Section
Nursing Research Study Section (NURS)
Project Start
1989-07-01
Project End
1994-06-30
Budget Start
1991-07-01
Budget End
1992-06-30
Support Year
3
Fiscal Year
1991
Total Cost
Indirect Cost
Name
University of Pittsburgh
Department
Type
Schools of Medicine
DUNS #
053785812
City
Pittsburgh
State
PA
Country
United States
Zip Code
15213
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Burgio, K L; Locher, J L; Zyczynski, H et al. (1996) Urinary incontinence during pregnancy in a racially mixed sample: characteristics and predisposing factors. Int Urogynecol J Pelvic Floor Dysfunct 7:69-73
Burgio, K L; Locher, J L; Ives, D G et al. (1996) Nocturnal enuresis in community-dwelling older adults. J Am Geriatr Soc 44:139-43
Burgio, K L; Ives, D G; Locher, J L et al. (1994) Treatment seeking for urinary incontinence in older adults. J Am Geriatr Soc 42:208-12
Towers, A L; Burgio, K L; Locher, J L et al. (1994) Constipation in the elderly: influence of dietary, psychological, and physiological factors. J Am Geriatr Soc 42:701-6
Merkel, I S; Locher, J; Burgio, K et al. (1993) Physiologic and psychologic characteristics of an elderly population with chronic constipation. Am J Gastroenterol 88:1854-9
McDowell, B J; Burgio, K L; Dombrowski, M et al. (1992) An interdisciplinary approach to the assessment and behavioral treatment of urinary incontinence in geriatric outpatients. J Am Geriatr Soc 40:370-4
Wald, A; Burgio, K; Holeva, K et al. (1992) Psychological evaluation of patients with severe idiopathic constipation: which instrument to use. Am J Gastroenterol 87:977-80
Burgio, K L; Matthews, K A; Engel, B T (1991) Prevalence, incidence and correlates of urinary incontinence in healthy, middle-aged women. J Urol 146:1255-9
Burgio, K L; Burgio, L D; McCormick, K A et al. (1991) Assessing toileting skills and habits in an adult day care center. J Gerontol Nurs 17:32-5