A non-interventional cross-sectional re-contact study investigating the relationship between overactive bladder and frailty in older adults in Japan

Abstract

Background Increasing age is associated with frailty and a higher prevalence of overactive bladder (OAB). Given the rapidly increasing proportion of older adults in Japan, a better understanding of the relationship between frailty and OAB is needed to inform future healthcare planning. This study assessed the association between frailty and OAB in older adults in Japan and evaluated the impact on their health-related quality of life (HRQoL). Methods This was a cross-sectional re-contact study of respondents who previously completed the National Health and Wellness Survey 2018 in Japan. Participants were aged ≥65 years and Japanese speakers and readers. As part of a customized online survey, participants were screened for frailty using the Kihon Checklist (frail = scores ≥8 points) and OAB using the overactive bladder symptom score (OAB = total score ≥ 3 points and ≥ 2 points on question 3). The primary endpoint was the odds ratio of frailty in older adults with and without OAB assessed using a multivariable logistic regression model. Secondary endpoints were the prevalence rates of OAB and frailty. Exploratory endpoints assessed HRQoL using the Medical Outcomes Study 12-Item Short Form Survey Instrument version 2 (SF-12v2). Results Overall, 2953 participants were included: 150 (5.1%) were frail OAB, 416 (14.1%) non-frail OAB, 287 (9.7%) frail non-OAB, and 2100 (71.1%) non-frail non-OAB. There was a statistically significant correlation between frailty and OAB demonstrated by an adjusted odds ratio (95% CI) of 2.78 (2.18–3.54; p < 0.001). The prevalence (95% CI) of OAB was 34.3% (29.9–38.8) in frail and 16.5% (15.1–18.0) in non-frail older adults; the prevalence of frailty was 26.5% (22.9–30.1) and 12.0% (10.7–13.3) in older adults with and without OAB. HRQoL was assessed in 150 participants per group. The adjusted HRQoL analyses showed significantly lower scores in participants who were frail OAB vs. frail non-OAB for most of the SF-12v2 scores/sub-component scores. Conclusions These data highlight the statistically significant positive correlation between frailty and OAB among older adults in Japan and may provide valuable information on the burden of OAB and frailty on older adults to healthcare professionals when considering future healthcare planning.

Ninjin’yoeito Improves Genitourinary Symptoms in Patients With Frailty

“…There are differing opinions among researchers regarding the relationship between frailty and OAB. In previous studies, Yoshida et al found a positive association between frailty and the occurrence of OAB in older individuals [ 5 ]. Out of 2,953 participants (65% men) aged 65 years or older, 150 (5.1%) had frail OAB, 416 (14.1%) had non-frail OAB, 287 (9.7%) had frail non-OAB, and 2,100 (71.1%) had non-frail non-OAB.…”

“…Frailty is a clinical condition associated with aging, characterized by muscle weakness and heightened susceptibility to internal and external stressors [ 3 , 4 ]. In the field of geriatric medicine, specifically urology, and gynecology, conditions such as overactive bladder (OAB) [ 5 ] and genitourinary syndrome of menopause (GSM) have been identified as having detrimental effects on the quality of life for older patients [ 6 , 7 ]. Similar to frailty, OAB and GSM stem from hormonal changes that lead to tissue frailty and significantly impact overall well-being [ 3 , 7 ].…”

“…Polypharmacy, especially in frail, older individuals, can result in drug interactions, and the failure to take medications or forgetting doses can hinder proper medication use, leading to various serious health problems [ 8 ]. There is also a connection between urology and social medicine in this context, as medications used for OAB often have notable anticholinergic effects [ 5 , 9 ].…”

High prevalence of frailty in patients with lower urinary tract symptoms

“…† In this study, benign prostatic hyperplasia, overactive bladder, neurogenic bladder, and stress urinary incontinence, which are representative diseases associated with LUTS, were classified as LUTS-related diseases. ‡ Others: hematuria (20), renal cyst (12), high PSA (8), cystocele (7), chronic prostatitis (7), hydronephrosis (4), renal angiomyolipoma (4), adrenal tumor (3), spermatocele (3), lower abdominal pain (3), urethral caruncle (2), retroperitoneal tumor (1), hematospermia (1), complete phimosis (1), erectile dysfunction (1), chronic renal failure (1), rectovesical fistula (1), skin erosion (1), spermatic cord sarcoidosis (1), scrotal subcutaneous hematoma (1). § Fisher's exact test.…”

“…In contrast, the prevalence of frailty associated with urological diseases in Japan has been reported only rarely. The prevalence of frailty assessed by the KCL for patients with overactive bladder (OAB) was 34.3% 12 . However, there are few reports that have examined the various urological diseases associated with a high prevalence of frailty the same criteria.…”