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Neil M. Resnick, MD
Harvard Medical School Boston, Mass

JAMA. 1989;262(18):2538.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

To the Editor.—

The careful study by Hu et al¹ is an important addition to the data regarding urinary incontinence in the nursing home. I write to request clarification of three points.

First, I am astonished by the durability of the response in a group of patients as debilitated as the ones included in this study (mean Mini-Mental State Examination score, 12.7; Katz score, 5.3). While some patients may have been motivated and able to continue to ask for toileting assistance, as shown in Fig 2 of the article, this "treatment effect" decayed by more than 50%, while the reduction in incontinent episodes declined by only 16%. Moreover, it is difficult to envision nonresearch nurse assistants voluntarily continuing a toileting regimen that requires hourly checks of all incontinent residents. Could the durability be an artifact due to the return of the nurse research assistants every 2 months to reassess . . . [Full Text PDF of this Article]

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