To examine the impact of frailty on treatment outcomes for overactive bladder (OAB) in older adults starting pharmacotherapy, onabotulinumtoxinA, and sacral neuromodulation.
This is a prospective study of men and women age ≥60 years starting pharmacotherapy, onabotulinumtoxinA, or sacral neuromodulation. Subjects were administered questionnaires at baseline and again at 1- and 3-months. Frailty was assessed at baseline using the timed up and go test (TUGT), whereby a TUGT time of ≥12 seconds was considered to be slow, or frail. Response to treatment was assessed using the overactive bladder symptom score (OABSS) and the OAB-q SF (both Bother and HRQOL subscales). Information on side effects/adverse events was also collected. Mixed effects linear modeling was used to model changes in outcomes over time both within and between groups.
A total of 45 subjects enrolled in the study, 40% (N = 18) of whom had a TUGT ≥12 seconds. Both TUGT groups demonstrated improvement in OAB symptoms over time and there were no statistically significant differences in these responses per group (all P-values >.05). Similar trends were found for both OAB-q SF Bother and OAB-q SF HRQOL questionnaire responses. Side effects and adverse events were not significantly different between groups (all P's >.05).
Adults ≥60 years of age starting second- and third-line treatments for OAB, regardless of TUGT time, demonstrated improvement in OAB symptoms at 3 months. These findings suggest that frail older adults may receive comparable benefit and similar rates of side effects compared with less frail older individuals.
Neurourology and urodynamics. 2019 Jul 08 [Epub ahead of print]
Anne M Suskind, Casey Kowalik, Kathryn Quanstrom, John Boscardin, Shoujun Zhao, W Stuart Reynolds, Kavita Mishra, Emily Finlayson
Department of Urology, University of California, San Francisco, California., Department of Urology, University of Kansas Medical Center, Kansas City, Missouri., Department of Biostatistics, Uinversity of California, San Francisco, California., Department of Urology, Vanderbilt University, Nashville, Tennessee., Department of Obstetrics and Gynecology, Standford University, California., Department of Surgery, University of California, San Francisco, California.