Frailty significantly predicts overactive bladder
Older patients with overactive bladder (OAB) appear to have increased frailty compared with individuals seeking care for other nononcologic urologic diagnosis, with frailty being a significant predictor of OAB, a study has found.
The prospective study included 201 OAB patients and 1,162 non-OAB individuals aged ≥65 years. All patients underwent a timed up-and-go test (TUGT), a measure of frailty, and were thereby categorized according to the results: fast (≤10 seconds), intermediate (11 to 14 seconds) and slow (≥15 seconds).
Logistic regression analysis was performed to examine the relationship between frailty and OAB. Adjustments for age, gender and race were made.
Results revealed that patients with OAB were significantly slower in the execution of TUGT compared with controls (13.7 vs 10.9 seconds; p<0.0001), with the proportion of individuals categorized as slow or frail being higher in the OAB group (32.3 vs 11.0 percent).
On multivariable analysis, slower TUGT was a significant predictor of OAB (adjusted odds ratio [OR], 3.0; 95 percent CI, 2.0 to 4.8). Age showed no independent association with the urologic condition (p>0.05).
The findings suggest that OAB patients aged ≥65 years are significantly frailer than individuals without the condition, and that frailty significantly predicts OAB. In light of the data, “frailty should be considered when caring for older patients with OAB, and OAB should be assessed when caring for frail older patients,” researchers said.
OAB is characterized by urinary frequency, nocturia and urgency with or without incontinence. In older adults, urinary incontinence and lower urinary tract symptoms are highly prevalent and are strongly associated with frailty. [LUTS 2012;4:48–55]
Frailty as a concept has been defined as “the accumulation of impairments” and as a phenotypic model. As a phenotype, frailty is said to be a biologic syndrome of decreased reserve and resistance to stressors, as a result of cumulative declines across multiple physiologic systems and causing vulnerability to adverse outcomes. By either definition, greater frailty is strongly linked to elevated mortality and risk of institutionalization. [Clin Pract 2014;11:431–440]