Lower Urinary Tract Symptoms and Risk of Nonspine Fractures among Older Community Dwelling U.S. Men.

Abstract

PURPOSE:

Among older men, moderate and severe lower urinary tract symptoms are associated with increased fall risk compared to mild lower urinary tract symptoms. Falls are a major risk factor for fractures. Therefore, we assessed associations of lower urinary tract symptoms with fracture risk in community dwelling U.S. men age 65 years or older.

MATERIALS AND METHODS:

We conducted a prospective study in the MrOS (Osteoporotic Fractures in Men Study) cohort. Men were enrolled at 6 U.S. sites. The AUA-SI, lower urinary tract symptoms medication use, fracture risk factors and potential confounders were recorded at baseline and every 2 years thereafter for 4 assessments. Lower urinary tract symptom severity was categorized from the AUA-SI as mild (0 to 7 points), moderate (8 to 19 points) or severe (20 or more points). Associations of lower urinary tract symptom severity with fracture rate were estimated with HRs and 95% CIs from extended proportional hazards regression.

RESULTS:

Among 5,989 men with baseline AUA-SI score and hip bone mineral density measures, 745 incident nonspine fractures occurred during 43,807 person-years of followup. In a multivariable model adjusted for age, enrollment site, baseline hip bone mineral density, falls in the last year and prevalent fracture before baseline, there were no significant associations of moderate (HR 0.9, 95% CI 0.8-1.1) or severe (HR 1.0, 95% CI 0.8-1.3) lower urinary tract symptoms with fracture risk. None of the individual lower urinary tract symptoms assessed on the AUA-SI, including nocturia and urgency, was associated with increased fracture risk.

CONCLUSIONS:

In this cohort of older U.S. men, lower urinary tract symptoms were not independently associated with fracture risk.

• Authors: Lynn M Marshall, Jodi A Lapidus, Jack Wiedrick, Elizabeth Barrett-Connor, Douglas C Bauer, Eric S Orwoll, J Kellogg Parsons, Osteoporotic Fractures in Men (MrOS) Research Group
• Journal: The Journal of urology (J Urol) Vol. 196 Issue 1 Pg. 166-72 (07 2016) ISSN: 1527-3792 [Electronic] United States
• PMID: 26905017 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
• Copyright: Copyright © 2016 American Urological Association Education and Research, Inc. Published by Elsevier Inc. All rights reserved.

Topics

• Accidental Falls
• Aged
• Aged, 80 and over
• Follow-Up Studies
• Fractures, Bone (etiology)
• Humans
• Independent Living
• Lower Urinary Tract Symptoms (complications)
• Male
• Prospective Studies
• Risk Factors
• United States