Co-Occurrence of Lower Urinary Tract Symptoms and Frailty among Community-Dwelling Older Men

for the Osteoporotic Fractures in Men (MrOS) Research Group

Research output: Contribution to journalArticlepeer-review

21 Scopus citations

Abstract

BACKGROUND/OBJECTIVES: To estimate associations between lower urinary tract symptoms (LUTS) and phenotypic frailty in older men. DESIGN: Cross-sectional study. SETTING: Community-dwelling men recruited from 2000 to 2002 from six U.S. academic centers for the Osteoporotic Fractures in Men Study. PARTICIPANTS: A total of 5,979 men aged 65 and older. MEASUREMENTS: The independent variable was LUTS severity (none/mild, moderate, or severe) assessed with the American Urologic Association Symptom Index. Participants were categorized as frail, intermediate stage, or robust using an adapted Cardiovascular Health Study index (components: low lean mass, weakness, exhaustion, slowness, and low physical activity). Associations were estimated with odds ratios and 95% confidence intervals (CIs) from multivariable multinomial logistic regression models adjusted for potential confounders of age, other demographics, health-related behaviors, and comorbidities. RESULTS: The prevalence of frailty was 7%, 11%, and 18% among men with none/mild, moderate, and severe LUTS, respectively. Moderate and severe LUTS, overall and by storage and voiding subscores, were associated with higher odds of both intermediate stage and frailty in all models. After adjustment for confounders, the odds of frailty was 1.41 times higher among men with moderate LUTS (95% CI = 1.14–1.74) and 2.51 times higher among men with severe LUTS (95% CI = 1.76–3.55), compared with none/mild LUTS. Severe LUTS was associated with a greater odds of individual frailty components exhaustion and low physical activity. CONCLUSION: The prevalence of phenotypic frailty is higher among older community-dwelling men with moderate or severe LUTS compared with those with mild or no LUTS. The positive association between LUTS severity and frailty among older men appears independent of age and known frailty risk factors. Although the temporal direction of this association and the utility of LUTS or frailty interventions in this population remain unclear, the high co-occurrence of these conditions could lead to earlier identification of frailty when clinically appropriate.

Original languageEnglish (US)
Pages (from-to)2805-2813
Number of pages9
JournalJournal of the American Geriatrics Society
Volume68
Issue number12
DOIs
StatePublished - Dec 2020

Bibliographical note

Funding Information:
Scott R. Bauer is supported by Grant No. 1K12DK111028 from the National Institute of Diabetes, Digestive, and Kidney Disorders. The Osteoporotic Fractures in Men Study is supported by National Institutes of Health (NIH) funding. The National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Institute on Aging, the National Center for Research Resources, and the NIH Roadmap for Medical Research provided support under Grant Nos. U01 AR45580, U01 AR45614, U01 AR45632, U01 AR45647, U01 AR45654, U01 AR45583, U01 AG18197, U01 AG027810, UL1 TR000128, and U54 104310. The authors have declared no conflicts of interest for this article. Conception and design, acquisition of data, analysis and interpretation of data, drafting and revising the article, and final approval of the version to be published: Bauer. Analysis and interpretation of data, revising the article for important intellectual content, and final approval of the version to be published: Scherzer, Suskind, Ensrud, Ricke, and Covinsky. Conception and design, acquisition of data, analysis and interpretation of data, revising the article for important intellectual content, and final approval of the version to be published: Cawthon and Marshall. No sponsors were involved in the study conception and design, acquisition of data, analysis and interpretation of data, drafting and revising the article, or final approval of the version to be published.

Funding Information:
Scott R. Bauer is supported by Grant No. 1K12DK111028 from the National Institute of Diabetes, Digestive, and Kidney Disorders. The Osteoporotic Fractures in Men Study is supported by National Institutes of Health (NIH) funding. The National Institute of Arthritis and Musculoskeletal and Skin Diseases, the National Institute on Aging, the National Center for Research Resources, and the NIH Roadmap for Medical Research provided support under Grant Nos. U01 AR45580, U01 AR45614, U01 AR45632, U01 AR45647, U01 AR45654, U01 AR45583, U01 AG18197, U01 AG027810, UL1 TR000128, and U54 104310.

Publisher Copyright:
© 2020 The American Geriatrics Society

Keywords

  • frailty
  • geriatric syndrome (1–5 Medical Subject Headings)
  • lower urinary tract symptoms
  • urinary incontinence

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