Naomi Noguchi1, Lewis Chan2, Robert G Cumming3, Fiona M Blyth4, David J Handelsman5, Markus J Seibel5, Louise M Waite4, David G Le Couteur6, Vasi Naganathan4. 1. Centre for Education and Research on Ageing, and Ageing and Alzheimer's Institute, New South Wales, Australia. Electronic address: nnog3510@uni.sydney.edu.au. 2. Department of Urology, Concord Hospital, University of Sydney, New South Wales, Australia. 3. Centre for Education and Research on Ageing, and Ageing and Alzheimer's Institute, New South Wales, Australia; School of Public Health, University of Sydney, New South Wales, Australia. 4. Centre for Education and Research on Ageing, and Ageing and Alzheimer's Institute, New South Wales, Australia. 5. ANZAC Research Institute, Concord Hospital, University of Sydney, New South Wales, Australia. 6. Centre for Education and Research on Ageing, and Ageing and Alzheimer's Institute, New South Wales, Australia; ANZAC Research Institute, Concord Hospital, University of Sydney, New South Wales, Australia.
Abstract
PURPOSE: We sought to determine which lower urinary tract symptoms are associated with incident falls in community dwelling older men. MATERIALS AND METHODS: The Concord Health and Ageing in Men Project involves a representative sample of community dwelling men 70 years old or older in a defined geographic region in Sydney, New South Wales, Australia. Included in analysis were 1,090 men without neurological diseases, poor mobility or dementia at baseline. Lower urinary tract symptoms were assessed using I-PSS (International Prostate Symptom Score) and incontinence was assessed using ICIQ (International Consultation on Incontinence Questionnaire) at baseline. I-PSS subscores were calculated for storage and voiding symptoms. Incident falls in 1 year were determined by telephone followup every 4 months. RESULTS: I-PSS storage and voiding subscores were associated with falls. Urgency incontinence was associated with falls (adjusted incidence rate ratio 2.57, 95% CI 1.54-4.30). In addition, intermediate to high I-PSS storage subscores without urgency incontinence were associated with falls (adjusted incidence rate ratio 1.72, 95% CI 1.24-2.38). Other types of incontinence and urgency alone without urgency incontinence were not associated with falls. CONCLUSIONS: Lower urinary tract storage and voiding symptoms were associated with falls in community dwelling older men. Of the symptoms of overactive bladder urgency incontinence carried a high risk of falls. Storage symptoms also contributed to the fall risk independently of urgency incontinence. Circumstances of falls among men with lower urinary tract symptoms should be explored to understand how lower urinary tract symptoms increase the fall risk and generate hypotheses regarding potential interventions. Furthermore, trials to treat lower urinary tract symptoms in older men should include falls as an end point.
PURPOSE: We sought to determine which lower urinary tract symptoms are associated with incident falls in community dwelling older men. MATERIALS AND METHODS: The Concord Health and Ageing in Men Project involves a representative sample of community dwelling men 70 years old or older in a defined geographic region in Sydney, New South Wales, Australia. Included in analysis were 1,090 men without neurological diseases, poor mobility or dementia at baseline. Lower urinary tract symptoms were assessed using I-PSS (International Prostate Symptom Score) and incontinence was assessed using ICIQ (International Consultation on Incontinence Questionnaire) at baseline. I-PSS subscores were calculated for storage and voiding symptoms. Incident falls in 1 year were determined by telephone followup every 4 months. RESULTS:I-PSS storage and voiding subscores were associated with falls. Urgency incontinence was associated with falls (adjusted incidence rate ratio 2.57, 95% CI 1.54-4.30). In addition, intermediate to high I-PSS storage subscores without urgency incontinence were associated with falls (adjusted incidence rate ratio 1.72, 95% CI 1.24-2.38). Other types of incontinence and urgency alone without urgency incontinence were not associated with falls. CONCLUSIONS: Lower urinary tract storage and voiding symptoms were associated with falls in community dwelling older men. Of the symptoms of overactive bladder urgency incontinence carried a high risk of falls. Storage symptoms also contributed to the fall risk independently of urgency incontinence. Circumstances of falls among men with lower urinary tract symptoms should be explored to understand how lower urinary tract symptoms increase the fall risk and generate hypotheses regarding potential interventions. Furthermore, trials to treat lower urinary tract symptoms in older men should include falls as an end point.
Authors: Pingli Wei; Ling Hao; Samuel Thomas; Amanda Rae Buchberger; Laura Steinke; Paul C Marker; William A Ricke; Lingjun Li Journal: J Am Soc Mass Spectrom Date: 2020-08-04 Impact factor: 3.109
Authors: Nicholas Faure Walker; Ashan Canagasingham; Danielle Van Diepen; Athina Pirpiris; Vincent Tse; Scott Leslie; Ruban Thanigasalam; Lewis Chan Journal: Int Neurourol J Date: 2021-01-19 Impact factor: 2.835