Lower urinary tract symptoms and incident functional limitations among older community-dwelling men

for the Osteoporotic Fractures in Men (MrOS) Research Group

doi:10.1111/jgs.17633

Lower urinary tract symptoms and incident functional limitations among older community-dwelling men

for the Osteoporotic Fractures in Men (MrOS) Research Group

Medicine - Veteran's Administration Medical Center

Research output: Contribution to journal › Article › peer-review

14 Scopus citations

Abstract

Background: Lower urinary tract symptoms (LUTS) are associated with frailty phenotype, a risk factor for functional decline. Our objective was to determine the association between baseline LUTS and 2-year risk of new functional limitation among older men. Methods: We analyzed data from the Osteoporotic Fractures in Men (MrOS) study with baseline at Year 7 and follow-up through Year 9. Participants included 2716 community-dwelling men age ≥ 71 years without any baseline self-reported functional limitation. LUTS severity (American Urologic Association Symptom Index) was classified as none/mild (score 0–7), moderate (8–19), and severe (20–35). At baseline and follow-up, men reported their ability to complete several mobility, activities of daily living (ADLs), and cognition-dependent tasks. Risk was estimated for 3 incident functional limitation outcomes: (1) mobility (any difficulty walking 2–3 blocks or climbing 10 steps), (2) ADL (any difficulty bathing, showering, or transferring), and (3) cognition-dependent (any difficulty managing money or medications). We used Poisson regression with a robust variance estimator to model adjusted risk ratios (ARR) and 95% CIs controlling for age, site, and comorbidities; other demographic/lifestyle factors did not meet criteria for inclusion. Results: Overall, the 2-year risk was 15% for mobility, 10% for ADLs, and 4% for cognition-dependent task limitations. Compared to none/mild LUTS, risk of incident mobility limitations was increased for moderate (ARR = 1.35, 95% CI: 1.12, 1.63) and severe LUTS (ARR = 1.98, 95% CI: 1.48, 2.64). Men were also at higher risk for incident ADL limitations if they reported moderate (ARR = 1.32, 95% CI: 1.05, 1.67) and severe LUTS (ARR = 1.62, 95% CI: 1.07,2.43). Results were somewhat attenuated after adjusting for the frailty phenotype but remained statistically significant. LUTS were not associated with incident cognition-dependent task limitations. Conclusions: LUTS severity is associated with incident mobility and ADL limitations among older men. Increased clinical attention to risk of functional limitations among older men with LUTS is likely warranted.

Original language	English (US)
Pages (from-to)	1082-1094
Number of pages	13
Journal	Journal of the American Geriatrics Society
Volume	70
Issue number	4
DOIs	https://doi.org/10.1111/jgs.17633
State	Published - Apr 2022

Bibliographical note

Funding Information:
This work was supported by grants to Scott R. Bauer from the National Institute of Diabetes, Digestive, and Kidney Disorders (grant number 1K12DK111028) and the National Institute on Aging (grant numbers 1R03AG067937 and K76AG074903) and the UCSF Claude D. Pepper Older Americans Independence Center funded by National Institute on Aging (grant number P30 AG044281 to Kenneth Covinsky). The Osteoporotic Fractures in Men (MrOS) Study is supported by National Institutes of Health funding from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Institute on Aging (NIA), the National Center for Research Resources (NCRR), and the NIH Roadmap for Medical Research (grant numbers U01 AR45580, U01 AR45614, U01 AG042145, U01 AR45632, U01 AR45647, U01 AR45654, U01 AR45583, U01 AG18197, U01 AG027810, R01 AG066671, and UL1 TR000128). Funding Information

Publisher Copyright:
© 2021 The American Geriatrics Society

Keywords

aging
benign prostatic hyperplasia
disability
epidemiology
functional health status

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10.1111/jgs.17633

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@article{e57e610337494a758472b3905e380bd7,

title = "Lower urinary tract symptoms and incident functional limitations among older community-dwelling men",

abstract = "Background: Lower urinary tract symptoms (LUTS) are associated with frailty phenotype, a risk factor for functional decline. Our objective was to determine the association between baseline LUTS and 2-year risk of new functional limitation among older men. Methods: We analyzed data from the Osteoporotic Fractures in Men (MrOS) study with baseline at Year 7 and follow-up through Year 9. Participants included 2716 community-dwelling men age ≥ 71 years without any baseline self-reported functional limitation. LUTS severity (American Urologic Association Symptom Index) was classified as none/mild (score 0–7), moderate (8–19), and severe (20–35). At baseline and follow-up, men reported their ability to complete several mobility, activities of daily living (ADLs), and cognition-dependent tasks. Risk was estimated for 3 incident functional limitation outcomes: (1) mobility (any difficulty walking 2–3 blocks or climbing 10 steps), (2) ADL (any difficulty bathing, showering, or transferring), and (3) cognition-dependent (any difficulty managing money or medications). We used Poisson regression with a robust variance estimator to model adjusted risk ratios (ARR) and 95% CIs controlling for age, site, and comorbidities; other demographic/lifestyle factors did not meet criteria for inclusion. Results: Overall, the 2-year risk was 15% for mobility, 10% for ADLs, and 4% for cognition-dependent task limitations. Compared to none/mild LUTS, risk of incident mobility limitations was increased for moderate (ARR = 1.35, 95% CI: 1.12, 1.63) and severe LUTS (ARR = 1.98, 95% CI: 1.48, 2.64). Men were also at higher risk for incident ADL limitations if they reported moderate (ARR = 1.32, 95% CI: 1.05, 1.67) and severe LUTS (ARR = 1.62, 95% CI: 1.07,2.43). Results were somewhat attenuated after adjusting for the frailty phenotype but remained statistically significant. LUTS were not associated with incident cognition-dependent task limitations. Conclusions: LUTS severity is associated with incident mobility and ADL limitations among older men. Increased clinical attention to risk of functional limitations among older men with LUTS is likely warranted.",

keywords = "aging, benign prostatic hyperplasia, disability, epidemiology, functional health status",

author = "{for the Osteoporotic Fractures in Men (MrOS) Research Group} and Bauer, {Scott R.} and Cawthon, {Peggy M.} and Ensrud, {Kristine E.} and Suskind, {Anne M.} and Newman, {John C.} and Fink, {Howard A} and Kaiwei Lu and Rebecca Scherzer and Hoffman, {Andrew R.} and Kenneth Covinsky and Marshall, {Lynn M.}",

note = "Funding Information: This work was supported by grants to Scott R. Bauer from the National Institute of Diabetes, Digestive, and Kidney Disorders (grant number 1K12DK111028) and the National Institute on Aging (grant numbers 1R03AG067937 and K76AG074903) and the UCSF Claude D. Pepper Older Americans Independence Center funded by National Institute on Aging (grant number P30 AG044281 to Kenneth Covinsky). The Osteoporotic Fractures in Men (MrOS) Study is supported by National Institutes of Health funding from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Institute on Aging (NIA), the National Center for Research Resources (NCRR), and the NIH Roadmap for Medical Research (grant numbers U01 AR45580, U01 AR45614, U01 AG042145, U01 AR45632, U01 AR45647, U01 AR45654, U01 AR45583, U01 AG18197, U01 AG027810, R01 AG066671, and UL1 TR000128). Funding Information Publisher Copyright: {\textcopyright} 2021 The American Geriatrics Society",

year = "2022",

month = apr,

doi = "10.1111/jgs.17633",

language = "English (US)",

volume = "70",

pages = "1082--1094",

journal = "Journal of the American Geriatrics Society",

issn = "0002-8614",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "4",

}

TY - JOUR

T1 - Lower urinary tract symptoms and incident functional limitations among older community-dwelling men

AU - for the Osteoporotic Fractures in Men (MrOS) Research Group

AU - Bauer, Scott R.

AU - Cawthon, Peggy M.

AU - Ensrud, Kristine E.

AU - Suskind, Anne M.

AU - Newman, John C.

AU - Fink, Howard A

AU - Lu, Kaiwei

AU - Scherzer, Rebecca

AU - Hoffman, Andrew R.

AU - Covinsky, Kenneth

AU - Marshall, Lynn M.

N1 - Funding Information: This work was supported by grants to Scott R. Bauer from the National Institute of Diabetes, Digestive, and Kidney Disorders (grant number 1K12DK111028) and the National Institute on Aging (grant numbers 1R03AG067937 and K76AG074903) and the UCSF Claude D. Pepper Older Americans Independence Center funded by National Institute on Aging (grant number P30 AG044281 to Kenneth Covinsky). The Osteoporotic Fractures in Men (MrOS) Study is supported by National Institutes of Health funding from the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), the National Institute on Aging (NIA), the National Center for Research Resources (NCRR), and the NIH Roadmap for Medical Research (grant numbers U01 AR45580, U01 AR45614, U01 AG042145, U01 AR45632, U01 AR45647, U01 AR45654, U01 AR45583, U01 AG18197, U01 AG027810, R01 AG066671, and UL1 TR000128). Funding Information Publisher Copyright: © 2021 The American Geriatrics Society

PY - 2022/4

Y1 - 2022/4

N2 - Background: Lower urinary tract symptoms (LUTS) are associated with frailty phenotype, a risk factor for functional decline. Our objective was to determine the association between baseline LUTS and 2-year risk of new functional limitation among older men. Methods: We analyzed data from the Osteoporotic Fractures in Men (MrOS) study with baseline at Year 7 and follow-up through Year 9. Participants included 2716 community-dwelling men age ≥ 71 years without any baseline self-reported functional limitation. LUTS severity (American Urologic Association Symptom Index) was classified as none/mild (score 0–7), moderate (8–19), and severe (20–35). At baseline and follow-up, men reported their ability to complete several mobility, activities of daily living (ADLs), and cognition-dependent tasks. Risk was estimated for 3 incident functional limitation outcomes: (1) mobility (any difficulty walking 2–3 blocks or climbing 10 steps), (2) ADL (any difficulty bathing, showering, or transferring), and (3) cognition-dependent (any difficulty managing money or medications). We used Poisson regression with a robust variance estimator to model adjusted risk ratios (ARR) and 95% CIs controlling for age, site, and comorbidities; other demographic/lifestyle factors did not meet criteria for inclusion. Results: Overall, the 2-year risk was 15% for mobility, 10% for ADLs, and 4% for cognition-dependent task limitations. Compared to none/mild LUTS, risk of incident mobility limitations was increased for moderate (ARR = 1.35, 95% CI: 1.12, 1.63) and severe LUTS (ARR = 1.98, 95% CI: 1.48, 2.64). Men were also at higher risk for incident ADL limitations if they reported moderate (ARR = 1.32, 95% CI: 1.05, 1.67) and severe LUTS (ARR = 1.62, 95% CI: 1.07,2.43). Results were somewhat attenuated after adjusting for the frailty phenotype but remained statistically significant. LUTS were not associated with incident cognition-dependent task limitations. Conclusions: LUTS severity is associated with incident mobility and ADL limitations among older men. Increased clinical attention to risk of functional limitations among older men with LUTS is likely warranted.

AB - Background: Lower urinary tract symptoms (LUTS) are associated with frailty phenotype, a risk factor for functional decline. Our objective was to determine the association between baseline LUTS and 2-year risk of new functional limitation among older men. Methods: We analyzed data from the Osteoporotic Fractures in Men (MrOS) study with baseline at Year 7 and follow-up through Year 9. Participants included 2716 community-dwelling men age ≥ 71 years without any baseline self-reported functional limitation. LUTS severity (American Urologic Association Symptom Index) was classified as none/mild (score 0–7), moderate (8–19), and severe (20–35). At baseline and follow-up, men reported their ability to complete several mobility, activities of daily living (ADLs), and cognition-dependent tasks. Risk was estimated for 3 incident functional limitation outcomes: (1) mobility (any difficulty walking 2–3 blocks or climbing 10 steps), (2) ADL (any difficulty bathing, showering, or transferring), and (3) cognition-dependent (any difficulty managing money or medications). We used Poisson regression with a robust variance estimator to model adjusted risk ratios (ARR) and 95% CIs controlling for age, site, and comorbidities; other demographic/lifestyle factors did not meet criteria for inclusion. Results: Overall, the 2-year risk was 15% for mobility, 10% for ADLs, and 4% for cognition-dependent task limitations. Compared to none/mild LUTS, risk of incident mobility limitations was increased for moderate (ARR = 1.35, 95% CI: 1.12, 1.63) and severe LUTS (ARR = 1.98, 95% CI: 1.48, 2.64). Men were also at higher risk for incident ADL limitations if they reported moderate (ARR = 1.32, 95% CI: 1.05, 1.67) and severe LUTS (ARR = 1.62, 95% CI: 1.07,2.43). Results were somewhat attenuated after adjusting for the frailty phenotype but remained statistically significant. LUTS were not associated with incident cognition-dependent task limitations. Conclusions: LUTS severity is associated with incident mobility and ADL limitations among older men. Increased clinical attention to risk of functional limitations among older men with LUTS is likely warranted.

KW - aging

KW - benign prostatic hyperplasia

KW - disability

KW - epidemiology

KW - functional health status

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U2 - 10.1111/jgs.17633

DO - 10.1111/jgs.17633

M3 - Article

C2 - 34951697

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SN - 0002-8614

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SP - 1082

EP - 1094

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

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ER -

Lower urinary tract symptoms and incident functional limitations among older community-dwelling men

Abstract

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