Thomas F Monaghan1, Adrian S Wagg2, Donald L Bliwise3, Christina W Agudelo4, Kyle P Michelson4, Syed N Rahman4, Matthew R Epstein4,5, Rebecca Haddad6,7, Karel Everaert6, Jason M Lazar8, Jeffrey P Weiss4. 1. Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA. monaghantf@gmail.com. 2. Department of Medicine, University of Alberta, Edmonton, Canada. 3. Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA. 4. Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA. 5. Department of Urology, Temple University Hospital, Philadelphia, PA, USA. 6. Department of Urology, Ghent University Hospital, Ghent, Belgium. 7. Sorbonne Université, UPMC Univ Paris 06, AP-HP GRC 01, Groupe de Recherche Clinique en Neuro-Urologie (GREEN), Service de Rééducation Neurologique, AP-HP, Hôpitaux Universitaires Est Parisien, Paris, France. 8. Department of Medicine, Division of Cardiovascular Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA.
Abstract
BACKGROUND: The relationship between frailty and nocturnal voiding is poorly understood. AIM: To characterize the association between frailty, as defined by a frailty index (FI) based upon the Canadian Study of Health and Aging (CSHA) criteria, and nocturia, defined by measures of nocturnal urine production. METHODS: Real-world retrospective analysis of voiding diaries from elderly males with lower urinary tract symptoms (LUTS) at an outpatient urology clinic. Males ≥ 65 years with ≥ 2 nocturnal voids were included. A modified FI was calculated from the LUTS database, which captured 39 variables from the original CSHA FI. Patients were divided into 3 groups by modified FI: low (≤ 0.077) (n = 59), intermediate (> 0.077 and < 0.179) (n = 58), and high (≥ 0.179) (n = 41). Diary parameters were compared using the Kruskal-Wallis test and pairwise comparisons with the Wilcoxon rank-sum test and Bonferroni adjustment. RESULTS: The high frailty group was characterized by higher nocturnal urine volume (NUV), maximum voided volume (MVV), nocturnal maximum voided volume (NMVV), and nocturnal urine production (NUP). The presence of comorbid diabetes mellitus did not explain this effect. CONCLUSION: Elderly males seeking treatment for LUTS with a high frailty burden are disproportionately affected by excess nocturnal urine production. Future research on the mechanistic relationship between urine production and functional impairment is warranted.
BACKGROUND: The relationship between frailty and nocturnal voiding is poorly understood. AIM: To characterize the association between frailty, as defined by a frailty index (FI) based upon the Canadian Study of Health and Aging (CSHA) criteria, and nocturia, defined by measures of nocturnal urine production. METHODS: Real-world retrospective analysis of voiding diaries from elderly males with lower urinary tract symptoms (LUTS) at an outpatient urology clinic. Males ≥ 65 years with ≥ 2 nocturnal voids were included. A modified FI was calculated from the LUTS database, which captured 39 variables from the original CSHA FI. Patients were divided into 3 groups by modified FI: low (≤ 0.077) (n = 59), intermediate (> 0.077 and < 0.179) (n = 58), and high (≥ 0.179) (n = 41). Diary parameters were compared using the Kruskal-Wallis test and pairwise comparisons with the Wilcoxon rank-sum test and Bonferroni adjustment. RESULTS: The high frailty group was characterized by higher nocturnal urine volume (NUV), maximum voided volume (MVV), nocturnal maximum voided volume (NMVV), and nocturnal urine production (NUP). The presence of comorbid diabetes mellitus did not explain this effect. CONCLUSION: Elderly males seeking treatment for LUTS with a high frailty burden are disproportionately affected by excess nocturnal urine production. Future research on the mechanistic relationship between urine production and functional impairment is warranted.
Authors: Scott R Bauer; Rebecca Scherzer; Anne M Suskind; Peggy Cawthon; Kristine E Ensrud; William A Ricke; Kenneth Covinsky; Lynn M Marshall Journal: J Am Geriatr Soc Date: 2020-08-21 Impact factor: 5.562
Authors: Scott R Bauer; Louise C Walter; Kristine E Ensrud; Anne M Suskind; John C Newman; William A Ricke; Teresa T Liu; Kevin T McVary; Kenneth Covinsky Journal: JAMA Netw Open Date: 2021-11-01