Little is known about the fall risk of older adults with overactive bladder, especially in the absence of urgency incontinence. We aimed to evaluate the impacts of overactive bladder with and without urgency incontinence (OAB-wet and OAB-dry) on the fall risk in older adults, and to investigate the importance of overactive bladder as a predictor of falls by using tree-based models.
This prospective cohort study included 630 community-dwelling, independent older adults aged≥75 years who attended a health checkup in 2017 with a 1-year follow-up. The associations of OAB-dry and OAB-wet with a fall history and future fall risk compared to no overactive bladder were assessed using logistic regression models. The contribution of overactive bladder as a predictor of falls was examined using a random forest and decision tree approach.
Of the 577 analyzed participants (median age: 79 years), 273 (47%) were men. The prevalence of OAB-dry and OAB-wet at baseline was 15% and 14%, respectively. Multivariable logistic regression analysis revealed that both OAB-dry and OAB-wet were associated with a higher likelihood of prior falls (adjusted odds ratio versus no overactive bladder, 2.03 and 2.21, respectively; 95% CI, 1.23-3.37 and 1.29-3.78, respectively). Among the 363 participants without a fall history, the adjusted odds ratios (95% CIs) of OAB-dry and OAB-wet for the occurrence of falls during the 1-year follow-up were 2.74 (1.19-6.29) and 1.35 (0.47-3.87), respectively. The tree-based approach used for all participants showed that overactive bladder was an important predictor of falls in adults without a fall history; the model had 83.6% accuracy and 81.8% AUC.
Overactive bladder, even in the absence of urgency incontinence, is an important predictor of falls in older adults with a low absolute fall risk.
The Journal of urology. 2020 Aug 28 [Epub ahead of print]
Kenji Omae, Noriaki Kurita, Taro Takeshima, Toru Naganuma, Sei Takahashi, Takashi Yoshioka, Tsuyoshi Ohnishi, Fumihito Ito, Sugihiro Hamaguchi, Shunichi Fukuhara
Department of Innovative Research and Education for Clinicians and Trainees (DiRECT), Fukushima Medical University Hospital, Fukushima, Japan., Center for Innovative Research for Communities and Clinical Excellence (CiRC2LE), Fukushima Medical University, Fukushima, Japan., Department of Nephrology, Kasukabe Central General Hospital, Saitama, Japan., Department of Clinical Epidemiology, Graduate School of Medicine, Fukushima Medical University, Fukushima, Japan.