Original Article| Volume 157, P34-39, March 2022

Gynecological aspects as a component of comprehensive geriatric assessment: A study of self-rated symptoms of pelvic organ prolapse among community-dwelling elderly women in Japan


      • In this study, 18% of community-dwelling elderly Japanese women reported symptoms of pelvic organ prolapse.
      • Self-reported pelvic organ prolapse was related to higher scores on the Timed Up and Go (TUG) test and reduced scores for basic activities of daily living.
      • Sex-specific symptoms were associated with reduced physical function in older women.



      Despite the reported ‘male-female health-survival paradox’, no components of the comprehensive geriatric assessment (CGA) routinely used in the field of geriatrics focus on female-specific symptoms. To investigate the impact of gynecological factors among elderly women, we noted the gynecological history and examined the association between self-rated symptoms of pelvic organ prolapse (POP) and CGA.

      Study design

      This community-based, cross-sectional study in Japan included 164 community-dwelling women aged ≥75 years.

      Main outcome measures

      The main outcome measures were the Pelvic Organ Prolapse Distress Inventory-6 (POPDI-6), activities of daily living (ADL), and Timed Up and Go (TUG) test. Self-rated symptoms of POP were assessed using POPDI-6, and the participants were dichotomized into POPDI-6 >0 (symptom group) and POPDI-6 = 0 (no-symptom group). Several components of the CGA were compared between the groups with and without symptoms of POP and the association with POPDI-6 score was analyzed by multiple logistic regression analysis.


      Compared with the no-symptom group, the symptom group had significantly longer TUG test time (≥13.5 s) (P = 0.024) and difficulty in basic ADL (score <21) (P = 0.02). In multiple logistic regression analysis, basic ADL <21 and TUG time 13.5 s were significantly associated with POPDI-6 >0 (odds ratio [OR] = 2.78; 95% confidence interval [CI] = 1.10–7.06 and OR = 3.45; 95% CI = 1.01–1.24).


      Self-rated POP symptoms were associated with CGA components among community-dwelling elderly women. Evaluating POP symptoms as part of the CGA could be meaningful for improving physical and psychological health in elderly women.



      ADL (activities of daily living), ANOVA (analysis of variance), CGA (comprehensive geriatric assessment), CI (confidence interval), FRI-5 (Fall Risk Index-5), GDS-5 (five-item version of the Geriatric Depression Scale), MMSE (Mini-Mental State Examination), OR (odds ratio), PFDI-20 (Pelvic Floor Distress Inventory-20), POP (pelvic organ prolapse), POPDI-6 (Pelvic Organ Prolapse Distress Inventory-6), QOL (quality of life), TLAS (Tosa Longitudinal Aging Study), TMIG-IC (Tokyo Metropolitan Institute of Gerontology Index of Competence), TUG (Timed Up and Go)
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