Is Barthel Index a relevant measure for measuring prevalence of urinary incontinence in stroke patients?

AIMS: To compare the prevalence of urinary incontinence (UI) measured by Barthel Index and the Danish Prostate Symptom Score (DAN-PSS-1) questionnaire in stroke patients.

METHODS: A cross-sectional, hospital based survey was initiated whereby 407 stroke patients, average age 67 (SD 12) years with a mean interval of 101 days since onset of last stroke at inclusion. The stroke patients self-reported the prevalence of UI by Barthel Index and the DAN-PSS-1 questionnaire.

RESULTS: The prevalence of UI was 10.5% measured by the Barthel Index and 49% by the DAN-PSS-1 questionnaire. Furthermore, the DAN-PSS-1 questionnaire distinguished between types of UI (38% urge UI, 28% stress UI, and 14% other UI). There were significantly fewer stroke patients who reported UI by the Barthel Index compared to the DAN-PSS questionnaire in term of urge UI (P < 0.001), stress UI (P < 0.001), and other UI (P < 0.001).

CONCLUSIONS: The results showed that DAN-PSS-1 questionnaire contains more specific UI information compared to the Barthel Index. Fewer stroke patients reported UI by the Barthel Index compared to the DAN-PSS-1 questionnaire and moreover the DAN-PSS-1 questionnaire enables identification of different UI-types. The Barthel Index is not sensitive to the UI prevalence; instead the authors suggest using a more specific instrument such as the DAN-PSS-1 questionnaire.