Objective: Stress urinary incontinence (SUI) is a common problem that affects the quality of life of women worldwide. Pelvic floor muscle training (PFMT) is an effective conservative first-line treatment for SUI. However, low compliance with PFMT is one of the main reasons for therapeutic failure. Indirect supervision using a guidebook may improve PFMT outcomes. To develop a PFMT guidebook using the analyze, design, development, implementation, and evaluation (ADDIE) method. Methods: A guidebook was developed from July 2020 to April 2021 using the ADDIE method. This prospective study used mixed methods, namely qualitative analysis, focus group discussions, and in-depth interviews, and involved various experts from urogynecology, urology, medical rehabilitation, and physiotherapy departments. A pilot study was conducted on patients with SUI to evaluate the effectiveness of the guidebook. Results: The ADDIE method was successfully implemented to develop the PFMT guidebook. The formative evaluation of the ADDIE steps mainly focused on the PFMT technique, content clarity, illustration, design, and color choice of the book. After the pilot study, the guidebook significantly improved Incontinence Impact Questionnaire, Short Form, 1-hour pad test, and perineometer scores. However, the pilot study showed no significant improvement in Urogenital Distress Inventory, Short Form scores. Conclusion The PFMT guidebook developed using the ADDIE method improved outcomes in patients with SUI.

Background: The co-occurrence of frailty, sarcopenia, and malnutrition was well studied in inpatient and nursing home settings, which was associated with higher risk of all-cause mortality. Multicentre data in community-dwelling outpatient setting were lacking. We aimed to find the prevalence of frailty, possible sarcopenia and malnutrition, their overlap and the associated factors in community-dwelling older outpatients. Methods: We collected data from community-dwelling outpatients aged ≥60 years in Indonesian geriatric care centres to conduct this cross-sectional study with bivariate and multivariable analyses. Frailty, possible sarcopenia, and malnutrition diagnoses were based on FRAIL scale, Asian Working Group for Sarcopenia 2019 consensus, and Mini Nutritional Assessment Short Form, respectively. Results: The prevalence of frailty, possible sarcopenia, and malnutrition in community-dwelling older outpatients were 13.6%, 45.5%, and 5.3%, respectively. The prevalence of co-occurrence of frailty, possible sarcopenia and malnutrition was 3.3%. It was associated with transient ischemic attack (TIA) and cerebrovascular accident (odds ratio [OR]=5.53, 95% confidence interval [CI] 1.48–20.61), cognitive impairment (OR=3.70, 95% CI 1.21–11.31), and dependent functional capacity (OR=11.62, 95% CI 3.38–39.99). Overlap of three evaluated syndromes was found in 24.1%, 7.2%, and 61.3% of subjects with frailty, possible sarcopenia, and malnutrition, respectively. It was characterized by a substantial proportion of female sex, older adults with low educational attainment, diabetes mellitus, hypertension, cognitive impairment, multimorbidity, and dependent functional status. Conclusion Approximately 1 in 30 community-dwelling older outpatients had overlapping frailty, possible sarcopenia, and malnutrition. The condition is associated with TIA and cerebrovascular accident, cognitive impairment, and dependent functional capacity. Standardized screening in community-dwelling older population is necessary.

Background: The co-occurrence of frailty, sarcopenia, and malnutrition was well studied in inpatient and nursing home settings, which was associated with higher risk of all-cause mortality. Multicentre data in community-dwelling outpatient setting were lacking. We aimed to find the prevalence of frailty, possible sarcopenia and malnutrition, their overlap and the associated factors in community-dwelling older outpatients. Methods: We collected data from community-dwelling outpatients aged ≥60 years in Indonesian geriatric care centres to conduct this cross-sectional study with bivariate and multivariable analyses. Frailty, possible sarcopenia, and malnutrition diagnoses were based on FRAIL scale, Asian Working Group for Sarcopenia 2019 consensus, and Mini Nutritional Assessment Short Form, respectively. Results: The prevalence of frailty, possible sarcopenia, and malnutrition in community-dwelling older outpatients were 13.6%, 45.5%, and 5.3%, respectively. The prevalence of co-occurrence of frailty, possible sarcopenia and malnutrition was 3.3%. It was associated with transient ischemic attack (TIA) and cerebrovascular accident (odds ratio [OR]=5.53, 95% confidence interval [CI] 1.48–20.61), cognitive impairment (OR=3.70, 95% CI 1.21–11.31), and dependent functional capacity (OR=11.62, 95% CI 3.38–39.99). Overlap of three evaluated syndromes was found in 24.1%, 7.2%, and 61.3% of subjects with frailty, possible sarcopenia, and malnutrition, respectively. It was characterized by a substantial proportion of female sex, older adults with low educational attainment, diabetes mellitus, hypertension, cognitive impairment, multimorbidity, and dependent functional status. Conclusion Approximately 1 in 30 community-dwelling older outpatients had overlapping frailty, possible sarcopenia, and malnutrition. The condition is associated with TIA and cerebrovascular accident, cognitive impairment, and dependent functional capacity. Standardized screening in community-dwelling older population is necessary.

Background: The co-occurrence of frailty, sarcopenia, and malnutrition was well studied in inpatient and nursing home settings, which was associated with higher risk of all-cause mortality. Multicentre data in community-dwelling outpatient setting were lacking. We aimed to find the prevalence of frailty, possible sarcopenia and malnutrition, their overlap and the associated factors in community-dwelling older outpatients. Methods: We collected data from community-dwelling outpatients aged ≥60 years in Indonesian geriatric care centres to conduct this cross-sectional study with bivariate and multivariable analyses. Frailty, possible sarcopenia, and malnutrition diagnoses were based on FRAIL scale, Asian Working Group for Sarcopenia 2019 consensus, and Mini Nutritional Assessment Short Form, respectively. Results: The prevalence of frailty, possible sarcopenia, and malnutrition in community-dwelling older outpatients were 13.6%, 45.5%, and 5.3%, respectively. The prevalence of co-occurrence of frailty, possible sarcopenia and malnutrition was 3.3%. It was associated with transient ischemic attack (TIA) and cerebrovascular accident (odds ratio [OR]=5.53, 95% confidence interval [CI] 1.48–20.61), cognitive impairment (OR=3.70, 95% CI 1.21–11.31), and dependent functional capacity (OR=11.62, 95% CI 3.38–39.99). Overlap of three evaluated syndromes was found in 24.1%, 7.2%, and 61.3% of subjects with frailty, possible sarcopenia, and malnutrition, respectively. It was characterized by a substantial proportion of female sex, older adults with low educational attainment, diabetes mellitus, hypertension, cognitive impairment, multimorbidity, and dependent functional status. Conclusion Approximately 1 in 30 community-dwelling older outpatients had overlapping frailty, possible sarcopenia, and malnutrition. The condition is associated with TIA and cerebrovascular accident, cognitive impairment, and dependent functional capacity. Standardized screening in community-dwelling older population is necessary.