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Mori S, Matsuo T, Honda H, Araki K, Mitsunari K, Ohba K, Imamura R. Relationship Between Overactive Bladder and Bone Fracture Risk in Female Patients. In Vivo 2024; 38:2031-2040. [PMID: 38936892 PMCID: PMC11215605 DOI: 10.21873/invivo.13661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2024] [Revised: 05/19/2024] [Accepted: 05/20/2024] [Indexed: 06/29/2024]
Abstract
BACKGROUND/AIM Overactive bladder (OAB) has recently been recognized as an independent risk factor for falls and fractures. This study aimed to predict fracture risk in female patients with OAB symptoms. PATIENTS AND METHODS We assessed and compared the fracture risk in newly diagnosed female patients with OAB to those without OAB using the Fracture Risk Assessment Tool (FRAX), and investigated the relationship between fracture risk and OAB severity. RESULTS The present single-center, cross-sectional study included 177 female participants (79 with OAB, 98 without OAB). The OAB group was older (p=0.033) and shorter (p=0.010) compared to the non-OAB group. Compared to the non-OAB group, the OAB group had more patients with hypertension (p<0.001) and diabetes mellitus (p=0.011), as well as higher risks for major fractures (non-OAB group: 15.2±13.2%; OAB group: 23.6±14.1%; p<0.001) and hip fractures (non-OAB group: 6.3±11.0%; OAB group: 10.6±10.0%; p=0.007). In addition, those with moderate/severe OAB had the most significantly elevated risks for both major fractures (non-OAB group: 15.2±13.2%, mild-OAB: 17.6±12.5%, moderate/sever-OAB: 26.4±14.0%; p<0.001) and hip fractures (non-OAB group: 6.3±11.0%, mild-OAB: 6.5±7.6%, moderate/sever-OAB: 12.5±10.4%; p<0.001). Among the OAB symptoms, nocturia had the strongest correlation with fracture risk (major fracture, ρ=0.534; hip fracture, ρ=0.449; all p<0.001). CONCLUSION Patients with severe OAB, and particularly severe nocturia, should be closely monitored with timely and aggressive symptom management; however, an interventional study incorporating the management of OAB symptoms is required to confirm whether the proactive management of OAB symptoms reduces the risk of fractures in older females.
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Affiliation(s)
- Shintaro Mori
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomohiro Matsuo
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Hiroyuki Honda
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kyohei Araki
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kensuke Mitsunari
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Kojiro Ohba
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Ryoichi Imamura
- Department of Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
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Zou M, Lu R, Jiang Y, Liu P, Tian B, Liang Y, Wang X, Jiang L. Association between toileting and falls in older adults admitted to the emergency department and hospitalised: a cross-sectional study. BMJ Open 2023; 13:e065544. [PMID: 37263694 DOI: 10.1136/bmjopen-2022-065544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/03/2023] Open
Abstract
OBJECTIVES This study aimed to explore the potential risk factors associated with toileting-related falls in community-dwelling older adults who presented to the emergency department and were subsequently hospitalised. DESIGN This was a cross-sectional study. SETTING AND PARTICIPANTS This study was conducted in two teaching hospitals in Shanghai, China between October 2019 and December 2021 among community-dwelling adults aged ≥60 years. METHODS In-person interviews, physical assessment and medical record review were performed to collect data on the characteristics and risk factors of falls. Associations of toileting-related falls with demographic characteristics and geriatric syndromes were examined using logistic regression models. MAIN OUTCOME MEASURES Potential risk factors for toileting-related falls. RESULTS This study included 419 older patients with a mean age of 73.8±9.7 years. Among 60 (14.3%) patients with toileting-related falls (mean age: 78.8±9.2 years), 63.3% of toileting-related falls, mainly occurred between 00:00 and 05:59 hours, compared with 17.3% of non-toileting-related falls, which primarily occurred during the daytime. The rate of recurrent falls (35%) was significantly higher in the toileting-related falls group than in the non-toileting-related falls group (21.2%) (p=0.02). Logistic regression showed that visual impairment (OR 2.7, 95% CI 1.1 to 7.1), cognitive impairment (OR 3.3, 95% CI 1.3 to 8.4), gait instability (OR 3.1, 95% CI 1.1 to 8.8) and urinary incontinence (OR 3.4, 95% CI 1.2 to 9.9) were strongly associated with toileting-related falls. Twenty-three (38.3%) patients in the toileting-related falls group had moderate and severe injuries, compared with 71.7% in the non-toileting-related falls group (p<0.05). CONCLUSIONS This study revealed that patients who reported toileting-related falls were more likely to have cognitive impairment, urinary incontinence, gait instability, visual impairment than patients who fell during other activities. Social and healthcare professionals should prioritise the management of toileting activities in older patients and provide targeted interventions to those in the high-risk group.
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Affiliation(s)
- Min Zou
- School of Nursing, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Emergency Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Rong Lu
- Emergency Department, Xinhua Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yijun Jiang
- Department of Pharmaceutics, Shanghai Pharmaceutical School, Shanghai, China
| | - Ping Liu
- Department of Nursing, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Bingjie Tian
- School of Nursing, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yuqi Liang
- School of Nursing, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - XiaoLing Wang
- Department of Nursing, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Liping Jiang
- Department of Nursing, Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
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Lv K, Wu Y, Huang S, Luo Z, Lai W, Meng Q, Xia X, Lv C, Hao X, Song T, Yuan Q. Age and metabolic syndrome are associated with unsatisfactory improvement in nocturia after holmium laser enucleation of the prostate. Front Surg 2023; 9:1063649. [PMID: 36704512 PMCID: PMC9871621 DOI: 10.3389/fsurg.2022.1063649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 12/12/2022] [Indexed: 01/11/2023] Open
Abstract
Objective To investigate the association between age, metabolic syndrome (MetS) and improvement in nocturia in patients with benign prostate hyperplasia (BPH) receiving holmium laser enucleation of the prostate (HoLEP). Methods The retrospective study was conducted on patients treated for BPH using HoLEP between January 2021 and May 2022. Lower urinary tract symptoms (LUTS) were measured before surgery and at 3 months postoperatively using the International Prostate Symptom Score (IPSS). The criteria of the Adult Treatment Panel III (ATP III) were adopted to diagnose the MetS. Unsatisfactory improvement in nocturia was defined as <50% reduction in nocturia from baseline on the IPSS. Results One hundred and seventy-five patients were eventually enrolled, with a median age of 69 years (IQR: 63/73). Unsatisfactory improvement in nocturia was reported in 95 patients (54%) after HoLEP. These patients were older (73; IQR: 67/79 vs. 66; IQR: 60/71, P < 0.001) and more likely to present with higher postoperative total (6; IQR: 4/9 vs. 3; IQR:2/5, P < 0.001), voiding (1; IQR: 0/3 vs. 1; IQR: 0/2, P = 0.017), and storage (4; IQR: 3/6 vs. 2; IQR: 1/4, P < 0.001) IPSS when compared to patients with satisfactory improvement in nocturia. Overall, 63 of 175 (36%) patients were diagnosed with MetS and of these, 44 (70%) reported unsatisfactory improvement in nocturia (P = 0.002) after HoLEP. Multivariate analysis revealed that age (OR = 1.117, 95% CI: 1.068-1.169, P < 0.001) and MetS (OR = 3.613, 95% CI: 1.727-7.562, P = 0.001) were independent risk factors for unsatisfactory improvement in nocturia after HoLEP. Conclusion Our findings suggest that increased age and MetS were associated with unsatisfactory improvement in nocturia in patients with BPH after HoLEP. Lifestyle management, including weight loss, may be of great importance in the improvement of nocturia.
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Affiliation(s)
- Kaikai Lv
- Department of Urology, the Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China,Medical School of Chinese People's Liberation Army (PLA), Beijing, China
| | - Yangyang Wu
- Department of Urology, the Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China,Medical School of Chinese People's Liberation Army (PLA), Beijing, China
| | - Shuai Huang
- Department of Postgraduate, Hebei North University, Zhangjiakou, Hebei, China
| | - Zhenjun Luo
- Affiliated Hospital of Weifang Medical University, School of Clinical Medicine, Weifang Medical University, Weifang, China
| | - Wenhui Lai
- Department of Postgraduate, Hebei North University, Zhangjiakou, Hebei, China
| | - Qingyang Meng
- Department of Urology, the Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China
| | - Xinze Xia
- Department of Urology, Shanxi Medical University, Taiyuan, Shanxi, China
| | - Chao Lv
- Medical School of Chinese People's Liberation Army (PLA), Beijing, China
| | - Xiaowei Hao
- Department of Urology, the Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China,Medical School of Chinese People's Liberation Army (PLA), Beijing, China
| | - Tao Song
- Department of Urology, the Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China,Medical School of Chinese People's Liberation Army (PLA), Beijing, China,Correspondence: Qing Yuan Tao Song
| | - Qing Yuan
- Department of Urology, the Third Medical Centre, Chinese People's Liberation Army (PLA) General Hospital, Beijing, China,Medical School of Chinese People's Liberation Army (PLA), Beijing, China,Correspondence: Qing Yuan Tao Song
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Yuen JWM, Wong IYP, Chiu PKF, Teoh JYC, Chan CK, Yee CH, Ng CF. Predictive Values of Nocturia and Its Voiding Frequency on the Aging Males' Symptoms. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:11632. [PMID: 36141927 PMCID: PMC9517266 DOI: 10.3390/ijerph191811632] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 09/10/2022] [Accepted: 09/13/2022] [Indexed: 06/16/2023]
Abstract
BACKGROUND The link between nocturia and aging male symptoms (AMS) has not been scientifically established. This study aimed to measure the degree of severity of AMS that impacts health-related quality of life (HRQoL) in adult males living with nocturia and to determine the predictive values of nocturnal factors on AMS. METHODS This is an extended analysis of new data collected by using the Hong Kong Traditional AMS (HK-AMS) scale and the Cantonese version of the Pittsburgh Sleep Quality Index (PSQI) in a recently published cross-sectional population-based survey. RESULTS Of the 781 respondents that completed the set of questionnaires, 68% and 61% of men living with nocturia reported clinically significant (at moderate-to-severe levels) somato-vegetative and sexual AMS; the prevalence and severity were increased with advancing nighttime voiding frequency. Age, the Global PSQI score, certain metabolic diseases, the nocturia-specific QoL (NQoL) score and bedtime voiding frequency were found to be significant predictive factors for composite somato-vegetative and sexual AMS. CONCLUSIONS The current findings suggested the inclusion of nocturia when measuring male-specific HRQoL related to aging.
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Affiliation(s)
- John Wai-Man Yuen
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Ivy Yuen-Ping Wong
- School of Nursing, The Hong Kong Polytechnic University, Hung Hom, Kowloon, Hong Kong
| | - Peter Ka-Fung Chiu
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Jeremy Yuen-Chun Teoh
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Chi-Kwok Chan
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Chi-Hang Yee
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
| | - Chi-Fai Ng
- S.H. Ho Urology Centre, Department of Surgery, The Chinese University of Hong Kong, Shatin, Hong Kong
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Mc Carthy CE. Sleep Disturbance, Sleep Disorders and Co-Morbidities in the Care of the Older Person. Med Sci (Basel) 2021; 9:medsci9020031. [PMID: 34063838 PMCID: PMC8162526 DOI: 10.3390/medsci9020031] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 05/17/2021] [Accepted: 05/18/2021] [Indexed: 01/14/2023] Open
Abstract
Sleep complaints can be both common and complex in the older patient. Their consideration is an important aspect of holistic care, and may have an impact on quality of life, mortality, falls and disease risk. Sleep assessment should form part of the comprehensive geriatric assessment. If sleep disturbance is brought to light, consideration of sleep disorders, co-morbidity and medication management should form part of a multifaceted approach. Appreciation of the bi-directional relationship and complex interplay between co-morbidity and sleep in older patients is an important element of patient care. This article provides a brief overview of sleep disturbance and sleep disorders in older patients, in addition to their association with specific co-morbidities including depression, heart failure, respiratory disorders, gastro-oesophageal reflux disease, nocturia, pain, Parkinson's disease, dementia, polypharmacy and falls. A potential systematic multidomain approach to assessment and management is outlined, with an emphasis on non-pharmacological treatment where possible.
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Affiliation(s)
- Christine E. Mc Carthy
- Department of Geriatric Medicine, University Hospital Galway, Galway, Ireland;
- HRB-Clinical Research Facility, National University of Ireland, Galway, Co., Galway, Ireland
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Calcium Channel Blockers Are Associated with Nocturia in Men Aged 40 Years or Older. J Clin Med 2021; 10:jcm10081603. [PMID: 33918949 PMCID: PMC8070101 DOI: 10.3390/jcm10081603] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 03/24/2021] [Accepted: 03/31/2021] [Indexed: 11/17/2022] Open
Abstract
BACKGROUND The associations of nocturia with hypertension and anti-hypertensive agents (AHTs) remain to be validated. METHODS This cross-sectional study examined whether blood pressure and/or frequently used classes of AHTs had consistent associations with nocturia. METHODS A total of 418 male patients aged ≥ 40 years were retrospectively assessed in terms of the International Prostate Symptom Score (IPSS), prescription medications, and blood pressure. Nocturia was evaluated using item 7 of the IPSS, and two or more episodes of nocturia per night was considered to indicate clinically important nocturia. RESULTS Patients taking calcium channel blockers (CCBs), but not other AHTs, experienced more episodes of nocturia than patients not taking AHTs (1.77 ± 1.07, 1.90 ± 1.19, and 1.48 ± 0.98 in CCBs alone, CCBs + other AHTs, and other AHTs alone, vs. 1.35 ± 1.08 in not taking AHTs; p = 0.014, p < 0.0001, and p = 0.91, respectively), whereas there was no significant difference in the number of nocturia episodes between patients with elevated and normal blood pressure. In multivariate analysis, CCB (odds ratio (OR) = 2.68, p < 0.0001) and age (OR = 1.06, p < 0.0001) were independently associated with clinically important nocturia. CONCLUSION CCB was associated with nocturia, while AHTs other than CCBs and elevated blood pressure were not.
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Analysis of the Associations between Arthritis and Fall Histories in Korean Adults. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18073758. [PMID: 33916869 PMCID: PMC8038444 DOI: 10.3390/ijerph18073758] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/18/2021] [Revised: 03/22/2021] [Accepted: 03/26/2021] [Indexed: 01/07/2023]
Abstract
(1) Background: the purpose of the present study was to analyze the associations between arthritis and fall histories in Korean adults. (2) Methods: data from the 2015 and 2017 Korean Community Health Survey were analyzed. In total, 322,962 participants aged ≥40 years were included. The participants were divided into two different groups. First, the participants were divided into the ‘arthritis (osteoarthritis or rheumatoid arthritis) for entire life’ and ‘nonarthritis for entire life (comparison I)’ groups. Subsequently, the participants were divided into the ‘current arthritis’ and ‘noncurrent arthritis (comparison II)’ groups. Afterwards, we analyzed the prevalence odds ratios (pORs) of the fall histories of the participants using a logistic regression analysis with the 95% confidence interval (CI). The variables of income, education level, region of residence, smoking status, alcohol consumption, obesity, subjective health status, stress level, physical activity, and sleep hours were adjusted for as covariates. (3) Results: both the arthritis for entire life and current arthritis groups had higher prevalence rates of falls than the comparison I and comparison II groups, respectively (each p < 0.001). The pORs of falling ≥1 time and ≥2 times per year in the arthritis for the entire life group were 1.42 (95% CI = 1.38–1.46) and 1.69 (95% CI = 1.62–1.76), respectively. The adjusted pORs for falling ≥1 time and ≥2 times per year in the current arthritis group were 1.35 (95% CI = 1.31–1.39) and 1.56 (95% CI = 1.50–1.63), respectively. (4) Conclusions: previous arthritis has a significant impact on the risk of falling.
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Prevalence of Nocturia in United States Women: Results From National Health and Nutrition Examination Survey. Female Pelvic Med Reconstr Surg 2021; 27:e52-e58. [DOI: 10.1097/spv.0000000000000792] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Hirsh SP, Pons M, Joyal SV, Swick AG. Self-Assessed Benefits of a Prostate Health Formulation on Nocturia in Healthy Males With Mild Lower Urinary Tract Symptoms: An Open Label Study. Glob Adv Health Med 2020; 9:2164956120973639. [PMID: 33294303 PMCID: PMC7705803 DOI: 10.1177/2164956120973639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2020] [Revised: 09/30/2020] [Accepted: 10/13/2020] [Indexed: 11/15/2022] Open
Abstract
Background Nocturia is the most bothersome lower urinary tract symptoms (LUTS) and can significantly reduce men's quality of life. It is often poorly managed with conventional treatments. Objective The purpose of this study was to evaluate the self-assessed benefits of a prostate health dietary combination formulation on mild LUTS, especially nocturia in healthy males. Methods In an open label clinical study, thirty healthy male subjects with mild LUTS took one daily capsule of the product for 60 days. The primary outcome was self-assessed severity of LUTS using the International Prostate Symptoms Score (IPSS) questionnaire at Day 1 (baseline), Day 30 and Day 60. Safety and compliance were also evaluated. Results At Day 60, IPSS significantly decreased from baseline by 16.3% (3.6 ± 2.1 vs. 4.3 ± 1.5, p < 0.05). Although the reduction in IPSS did not reach statistical significance at Day 30, it was mostly driven by a 30.7% decrease (p < 0.05) in the nocturia sub-score compared with baseline. While 37% of subjects reported at baseline waking up 2‒3 times/night to void, none did so after taking the study product for 60 days. Compliance was very high throughout the study. No adverse events related to the study product were reported. Conclusions The study product might be a safe alternative for individuals willing to explore a non-conventional approach to manage their nocturia. A larger randomized placebo-controlled clinical trial is warranted to confirm these results. Clinical trial registry: Clinical Trials.gov. Registration number (September 1st, 2016): NCT02886832.
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Affiliation(s)
- Steven P Hirsh
- Life Extension Clinical Research, Inc., Fort Lauderdale, Florida
| | - Marianne Pons
- Life Extension, Inc., Fort Lauderdale, Florida
- Marianne Pons, Life Extension, Inc., 3600 West Commercial Boulevard, Fort Lauderdale, FL 33309, USA.
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Tanner L, Thomson K, Drake MJ, Ervin CF, Bower WF, Pearson F. Behavioural interventions for nocturia in adults. Hippokratia 2020. [DOI: 10.1002/14651858.cd013746] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Affiliation(s)
- Louise Tanner
- Evidence Synthesis Group, Population Health Sciences Institute; Newcastle University; Newcastle upon Tyne UK
| | - Katie Thomson
- Evidence Synthesis Group, Population Health Sciences Institute; Newcastle University; Newcastle upon Tyne UK
| | - Marcus J Drake
- School of Clinical Sciences; University of Bristol; Bristol UK
| | - Claire F Ervin
- Department of Medicine and Aged Care; The Royal Melbourne Hospital; Parkville Australia
| | - Wendy F Bower
- Department of Medicine and Aged Care; The Royal Melbourne Hospital; Parkville Australia
| | - Fiona Pearson
- Evidence Synthesis Group, Population Health Sciences Institute; Newcastle University; Newcastle upon Tyne UK
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Nocturia in Women With Type 2 Diabetes Mellitus: A Cross-sectional, Correlation Study. J Wound Ostomy Continence Nurs 2020; 47:265-272. [PMID: 32195774 DOI: 10.1097/won.0000000000000635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
PURPOSE The first aim of this study was to compare nighttime voiding frequency (nocturia), serum hemoglobin A1c level, peripheral neuropathy score, and global sleep quality score in younger (>40 to <65 years) versus older (≥65 years) women with type 2 diabetes mellitus (DM). Additional aims were to identify factors associated with clinically relevant nocturia (≥2 episodes/night) and to analyze relationships between nocturia frequency, glycemic control, peripheral neuropathy, and sleep quality in these women. DESIGN Cross-sectional study. SETTING AND SUBJECTS Participants were 118 women older than 40 years and with type 2 DM. Their mean age was 65.25 (SD = 9.66) years; the mean duration since diagnosis of type 2 DM was 10.96 (SD = 7.66) years. The study setting was 2 metabolism and endocrinology outpatient departments located in Taipei City and Taoyuan, Taiwan. METHODS Data were collected using a questionnaire that queried sociodemographic information, lower urinary tract symptoms, and sleep quality. We also assessed peripheral neuropathy and lower extremity edema and obtained pertinent information from participants' medical records. Independent t tests, multivariate logistic regression analyses, Spearman's rank correlation coefficients, and one-way analysis of variance were used to address the 3 study aims. RESULTS Analyses found that older women (aged ≥65 years) had a significantly higher nighttime voiding frequency, a higher peripheral neuropathy score, and a higher sleep quality score than younger (>40 to <65 years) women. Multivariate logistic regression analyses identified 4 factors associated with clinically relevant nocturia advanced age, elevated hemoglobin A1c level, suspected peripheral neuropathy, and lower extremity edema. Significant correlation coefficients were found between nighttime voiding frequency and serum hemoglobin A1c levels, peripheral neuropathy scores, and sleep quality scores. Analyses also found that women with a greater nocturia frequency had higher hemoglobin A1c levels, peripheral neuropathy scores, and sleep quality scores. CONCLUSIONS Healthcare professionals should screen for nocturia in women with type 2 DM and provide appropriate management for those experiencing nocturia.
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Trends and prevalence of nocturia among US adults, 2005-2016. Int Urol Nephrol 2019; 52:805-813. [PMID: 31858342 DOI: 10.1007/s11255-019-02361-5] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 12/11/2019] [Indexed: 12/28/2022]
Abstract
PURPOSE Increased nocturia episodes can be a clinical marker of poor health status. The present study aimed to evaluate patterns and temporal trends in nocturia and sociodemographic and lifestyle correlates in the US population. METHODS Participants, aged 20 years or older, were included in this repeated cross-sectional study. The National Health and Nutrition Examination Survey from 2005 to 2016 was used. Participants were asked "During the past 30 days, how many times per night did you most typically get up to urinate, from the time you went to bed at night until the time you got up in the morning?". Individuals were categorized as either ≥ 1 nocturia episode or ≥ 2 nocturia episodes per night. RESULTS The estimated prevalence of ≥ 1 nocturia was high among men (20-39 years, 56.8%; 40-59 years, 70.2%; ≥ 60 years, 82.7%) and women (20-39 years, 68.9%; 40-59 years, 74.3%; ≥ 60 years, 84.7%), particularly in Non-Hispanic-blacks. From 2005-2016, the trends in prevalence of ≥ 1 nocturia increased for the age groups 20-39 and 40-59 years among men (p < 0.001 and p = 0.001, respectively) and women 20-39 and 40-59 years (p < 0.001 and p = 0.032, respectively), but a stable trend was observed among men and women who were 60 years and older (p = 0.814, and p = 0.64, respectively). A significant increasing trend of ≥ 2 nocturia episodes was observed among men only aged 40-59 years (p = 0.007). CONCLUSIONS From 2005 through 2016, the secular trend in the frequency of nocturia increased in both men and women in general, which was significant under the age of 60 years, particularly in Non-Hispanic-blacks.
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Gratza SK, Chocano-Bedoya PO, Orav EJ, Fischbacher M, Freystätter G, Theiler R, Egli A, Kressig RW, Kanis JA, Bischoff-Ferrari HA. Influence of fall environment and fall direction on risk of injury among pre-frail and frail adults. Osteoporos Int 2019; 30:2205-2215. [PMID: 31377914 DOI: 10.1007/s00198-019-05110-7] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/17/2019] [Accepted: 07/24/2019] [Indexed: 12/29/2022]
Abstract
UNLABELLED In this prospective study, half of all falls resulted in injury. Pre-frail adults sustained more injuries, while more frail adults had injuries requiring hospitalization or fractures. Pre-frail adults fell more often when in movement compared with frail adults who fell more often when standing and in indoor public spaces. PURPOSE To assess prospectively how fall environment and direction are related to injury among pre-frail and frail adults. METHODS We included 200 community-dwelling adults with a prior fall (pre-frail, mean age 77 years) and 173 adults with acute hip fracture (frail, mean age 84 years; 77% community-dwelling). Falls were prospectively recorded using standardized protocols in monthly intervals, including date, time, fall direction and environment, and injury. We used logistic regression to assess the odds of injury adjusting for age, body mass index (BMI), and gender. RESULTS We recorded 513 falls and 331 fall-related injuries (64.5%) among the 373 participants. While the fall rate was similar between groups, pre-frail adults had more injuries (71% among pre-frail vs. 56% among frail, p = 0.0004) but a lower incidence of major injuries (9% among pre-frail vs. 27% among frail, p = 0.003). Pre-frail adults fell more often while in movement (84% among pre-frail vs. 55% among frail, p < 0.0001), and frail adults fell more often while standing (26% vs. 15% respectively, p = 0.01). The odds of injury among frail adults was increased 3.3-fold when falling sideways (OR = 3.29, 95% CI = 1.68-6.45) and 2.4-fold when falling in an indoor public space (OR = 2.35, 95% CI = 1.00-5.53), and was reduced when falling at home (OR = 0.55, 95% CI = 0.31-0.98). The odds of injury among pre-frail adults was not influenced by environment and was 53% lower when falling backwards (OR = 0.47, 95% CI = 0.26-0.82). CONCLUSION While pre-frail adults sustain more fall-related injuries, frail adults were more likely to sustain major injuries, especially when falling sideways or outside their home.
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Affiliation(s)
- S K Gratza
- Centre on Aging and Mobility, University Hospital Zurich, Waid City Hospital, and University of Zurich, Zurich, Switzerland
- Basel University Medicine of Aging, Felix-Platter Spital, Basel, Switzerland
| | - P O Chocano-Bedoya
- Centre on Aging and Mobility, University Hospital Zurich, Waid City Hospital, and University of Zurich, Zurich, Switzerland
| | - E J Orav
- Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA
| | - M Fischbacher
- Centre on Aging and Mobility, University Hospital Zurich, Waid City Hospital, and University of Zurich, Zurich, Switzerland
- School of Allied Health Sciences, Griffith University, Gold Coast, Australia
| | - G Freystätter
- Centre on Aging and Mobility, University Hospital Zurich, Waid City Hospital, and University of Zurich, Zurich, Switzerland
- Department of Geriatrics and Aging Research, University Hospital Zurich, Raemistrasse 101, 8091, Zurich, Switzerland
| | - R Theiler
- Centre on Aging and Mobility, University Hospital Zurich, Waid City Hospital, and University of Zurich, Zurich, Switzerland
- Department of Geriatrics and Aging Research, University Hospital Zurich, Raemistrasse 101, 8091, Zurich, Switzerland
| | - A Egli
- Centre on Aging and Mobility, University Hospital Zurich, Waid City Hospital, and University of Zurich, Zurich, Switzerland
| | - R W Kressig
- Basel University Medicine of Aging, Felix-Platter Spital, Basel, Switzerland
| | - J A Kanis
- Mary McKillop Health Institute, Australian Catholic University, Melbourne, Australia
- Centre of Metabolic Bone Diseases, University of Sheffield Medical School, Sheffield, UK
| | - H A Bischoff-Ferrari
- Centre on Aging and Mobility, University Hospital Zurich, Waid City Hospital, and University of Zurich, Zurich, Switzerland.
- Department of Geriatrics and Aging Research, University Hospital Zurich, Raemistrasse 101, 8091, Zurich, Switzerland.
- University Clinic for Acute Geriatric Care, City Hospital Waid, Zurich, Switzerland.
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Rose G, Decalf V, Everaert K, Bower WF. Toileting-related falls at night in hospitalised patients: The role of nocturia. Australas J Ageing 2019; 39:e70-e76. [PMID: 31321899 DOI: 10.1111/ajag.12696] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 05/21/2019] [Accepted: 06/11/2019] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The purpose of this study was to describe the prevalence and characteristics of toileting-related falls in hospitalised older people. METHODS Retrospective analysis of falls related to night-time toileting in patients 60 years or over in a tertiary hospital during a one-year period. RESULTS Overall 34% of falls were related to toileting with at least 44% of these falls occurring during the night. Toilet-related falls peaked between 11 pm and 1 am, a period that coincides with maximum supine-induced diuresis. Almost half of night falls occurred at the bedside. In 80% of night toileting-related falls, patients were mobilising without the recommended level of assistance. Half of all patients had no strategies for toileting documented in their care plan. CONCLUSION Findings support screening for nocturia in older inpatients and implementation of strategies to reduce both the need for toileting at night and risk factors for falling.
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Affiliation(s)
- Georgie Rose
- Department of Medicine & Aged Care, The Royal Melbourne Hospital, Melbourne, Victoria, Australia
| | - Veerle Decalf
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - Karel Everaert
- Department of Urology, Ghent University Hospital, Ghent, Belgium
| | - Wendy F Bower
- Department of Medicine & Aged Care, The Royal Melbourne Hospital, Melbourne, Victoria, Australia.,Faculty of Medicine, Dentistry & Health Sciences, The University of Melbourne, Melbourne, Australia
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15
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Health-related quality of life in adult males with lower urinary tract symptoms. Qual Life Res 2019; 28:2419-2428. [PMID: 31087248 DOI: 10.1007/s11136-019-02205-w] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/06/2019] [Indexed: 02/07/2023]
Abstract
PURPOSE To assess the status and impact of lower urinary tract symptoms (LUTS) on health-related quality of life (HRQoL) in a community-based sample of Korean adult males. METHODS We analyzed the data of 101,606 adult males aged ≥ 19 years of age obtained during the 2011 Korean Community Health Survey. Subject data were assessed for LUTS and HRQoL using international prostate symptom scores, and EuroQol-five-dimensions three-level version (EQ-5D-3L) and EuroQol-visual analogue scale (EQ-VAS) scores. RESULTS Of the 101,606 subjects, 53,323 (52.5%) reported having at least one LUTS and 3116 (3.1%) had an IPSS of ≥ 20, indicating severe LUTS. In those aged 19-39 years, 28.7% (8343/29,072) reported they had mild to severe LUTS. The prevalence of LUTS was high among those aged 40-59 years (47.7%), 60-79 years (80.5%), and ≥ 80 years (91.2%). In addition, EQ-5D-3L and EQ-VAS scores decreased as LUTS severity and frequency increased. CONCLUSIONS Adult men of all ages with mild to severe LUTS have poorer health statuses and quality of life. Even among young males, LUTS severity and was found to negatively affect HRQoL.
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Kim JS, Chung HS, Yu JM, Cho ST, Moon S, Yoo HJ. Analyzing the Factors Associated With Nocturia in Older People in the United States. Ann Geriatr Med Res 2018; 22:184-188. [PMID: 32743271 PMCID: PMC7387627 DOI: 10.4235/agmr.18.0044] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2018] [Revised: 11/20/2018] [Accepted: 11/21/2018] [Indexed: 11/18/2022] Open
Abstract
Background The risk factors of nocturia in older adults remain unclear. We aimed to investigate factors associated with nocturia using the National Health and Nutrition Examination Survey (NHANES) data. Methods Among 40,790 participants, 4,698 participants aged ≥65 years were included from the NHANES dataset between 2005 and 2012. A multivariate logistic regression analysis was performed to determine the odds ratio (OR) for nocturia. A subgroup analysis was conducted based on sex and underlying diseases. Results In the multivariate logistic regression model, obesity (OR, 1.46; 95% confidence interval [CI], 1.28–1.68), hypertension (OR, 1.28; 95% CI, 1.07–1.52), and diabetes mellitus (DM) (OR, 1.27; 95% CI, 1.11–1.45) were significantly associated with nocturia. These factors were associated with nocturia regardless of sex. In a subgroup of participants with hypertension, obesity (OR, 1.44; 95% CI, 1.25–1.67) and DM (OR, 1.26; 95% CI, 1.09–1.45) were associated with nocturia. In the additional analysis on patients with DM, nocturia was associated with obesity (OR, 1.33; 95% CI, 1.06–1.67) and duration of DM (OR, 1.02; 95% CI, 1.01–1.03). Conclusion This study demonstrated that hypertension, DM, and obesity were significantly associated with the prevalence of nocturia in older adult patients regardless of sex. In particular, obesity was associated with nocturia in every subgroup analysis.
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Affiliation(s)
- Joo Seop Kim
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Hye Soo Chung
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Jae Myung Yu
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Sung Tae Cho
- Department of Urology, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Shinje Moon
- Department of Internal Medicine, Hallym University Kangnam Sacred Heart Hospital, Hallym University College of Medicine, Seoul, Korea
| | - Hyung Joon Yoo
- Department of Internal Medicine, CM Hospital, Seoul, Korea
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A Survey of Accidental Fall - induced Injuries and Mortality in a Central Trauma Hospital in Iran: 2015 - 2016. Trauma Mon 2018. [DOI: 10.5812/traumamon.14285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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18
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Metabolic syndrome and smoking are associated with an increased risk of nocturia in male patients with benign prostatic enlargement. Prostate Cancer Prostatic Dis 2017; 21:287-292. [PMID: 29203892 DOI: 10.1038/s41391-017-0003-z] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2017] [Accepted: 07/12/2017] [Indexed: 11/08/2022]
Abstract
BACKGROUND To evaluate the relationship between cigarette smoking, metabolic syndrome (MetS) and nocturia in patients with lower urinary tract symptoms (LUTS) and benign prostatic enlargement (BPE). METHODS From 2009 onward, a consecutive series of patients with LUTS/BPE were enrolled. Symptoms were assessed using the International Prostate Symptom Score (IPSS). Age, body mass index (BMI), smoker status, prostate volume (PV), prostate-specific antigen (PSA) levels, fasting glucose levels, triglyceride levels, and high-density lipoprotein levels were recorded. MetS was defined according to Adult Treatment Panel III criteria. Moderate/severe nocturia was defined as nocturnal micturition episodes ≥2. RESULTS Overall 492 patients were enrolled with median age and BMI of 68 years (IQR 61/74) and 26.5 kg/m2 (IQR: 24/29), respectively. Moderate/severe nocturia was reported in 212 (43.1%) patients. MetS was diagnosed in 147 (29.9%) patients and out of them 89 (60.5%) complained moderate/severe nocturia (p = 0.001). Overall 187 (38%) patients were current smokers and out of them 99 (52%) presented moderate/severe nocturia(p = 0.034). Patients with moderate/severe nocturia were older (p = 0.001) and with larger prostate volume (p = 0.003). On multivariate analysis, age (OR: 1.067 per year, 95% CI: 1.036-1.098; p = 0.001), PV (OR: 1.011 per ml, 95% CI: 1.003-1.019; p = 0.006), MetS (OR: 2.509, 95% CI: 1.571-4.007; p = 0.001) and smoking (OR: 1.690, 95% CI: 1.061-2.693; p = 0.027) were associated with nocturia severity. CONCLUSIONS MetS and smoking doubled the risk of moderate/severe nocturia in patients with LUTS and BPE. Assessing smoking and metabolic status in LUTS/ BPE patients is suggested.
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Oelke M, De Wachter S, Drake MJ, Giannantoni A, Kirby M, Orme S, Rees J, van Kerrebroeck P, Everaert K. A practical approach to the management of nocturia. Int J Clin Pract 2017; 71:e13027. [PMID: 28984060 PMCID: PMC5698733 DOI: 10.1111/ijcp.13027] [Citation(s) in RCA: 54] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 09/11/2017] [Indexed: 12/11/2022] Open
Abstract
AIM To raise awareness on nocturia disease burden and to provide simplified aetiologic evaluation and related treatment pathways. METHODS A multidisciplinary group of nocturia experts developed practical advice and recommendations based on the best available evidence supplemented by their own experiences. RESULTS Nocturia is defined as the need to void ≥1 time during the sleeping period of the night. Clinically relevant nocturia (≥2 voids per night) affects 2%-18% of those aged 20-40 years, rising to 28%-62% for those aged 70-80 years. Consequences include the following: lowered quality of life; falls and fractures; reduced work productivity; depression; and increased mortality. Nocturia-related hip fractures alone cost approximately €1 billion in the EU and $1.5 billion in the USA in 2014. The pathophysiology of nocturia is multifactorial and typically related to polyuria (either global or nocturnal), reduced bladder capacity or increased fluid intake. Accurate assessment is predicated on frequency-volume charts combined with a detailed patient history, medicine review and physical examination. Optimal treatment should focus on the underlying cause(s), with lifestyle modifications (eg, reducing evening fluid intake) being the first intervention. For patients with sustained bother, medical therapies should be introduced; low-dose, gender-specific desmopressin has proven effective in nocturia due to idiopathic nocturnal polyuria. The timing of diuretics is an important consideration, and they should be taken mid-late afternoon, dependent on the specific serum half-life. Patients not responding to these basic treatments should be referred for specialist management. CONCLUSIONS The cause(s) of nocturia should be first evaluated in all patients. Afterwards, the underlying pathophysiology should be treated specifically, alone with lifestyle interventions or in combination with drugs or (prostate) surgery.
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Affiliation(s)
- Matthias Oelke
- Department of UrologyUniversity of MaastrichtMaastrichtThe Netherlands
| | | | | | - Antonella Giannantoni
- Department of Surgical and Biomedical Sciences, Urology and Andrology UnitUniversity of PerugiaPerugiaItaly
| | - Mike Kirby
- The Centre for Research in Primary and Community CareThe University of Hertfordshire and The Prostate CentreLondonUK
| | - Susan Orme
- Department of Geriatric MedicineBarnsley Hospital NHS Foundation Trust HospitalBarnsleyUK
| | | | | | - Karel Everaert
- Department of UrologyGhent University HospitalGhentBelgium
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