Association Between Nocturia and Fractures in a Community-Dwelling Elderly Population Aged 70 Years and Over: Results of a 3-Year Prospective Cohort Study in Japan

Nakagawa, Haruo; Ikeda, Yoshihiro; Kaiho, Yasuhiro; Nakaya, Naoki; Omori, Kaori; Niu, Kaijun; Kuriyama, Shinichi; Nagatomi, Ryoichi; Tsuji, Ichiro; Arai, Yoichi

doi:10.1016/s0022-5347(08)60410-3

Cited by 5 publications

(8 citation statements)

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“…Resource use was obtained from various sources: the two abovementioned surveys [23, 25], the clinical authors, and published literature [20–22]. Some data were not available; thus, the following assumptions were made:

If a patient was referred to a specialist, only one additional specialist visit was assumed.

Patients would initially visit their family practitioner in Sweden and the UK.

Patients who have a fall would visit an accident and emergency department; those with fractures would require some type of fracture-related procedure in a hospital.

…”

Section: Methodsmentioning

confidence: 99%

Annual direct and indirect costs attributable to nocturia in Germany, Sweden, and the UK

et al. 2016

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ObjectiveOur aim was to estimate the prevalence-based cost of illness imposed by nocturia (≥2 nocturnal voids per night) in Germany, Sweden, and the UK in an average year.MethodsInformation obtained from a systematic review of published literature and clinicians was used to construct an algorithm depicting the management of nocturia in these three countries. This enabled an estimation of (1) annual levels of healthcare resource use, (2) annual cost of healthcare resource use, and (3) annual societal cost arising from presenteeism and absenteeism attributable to nocturia in each country.ResultsIn an average year, there are an estimated 12.5, 1.2, and 8.6 million patients ≥20 years of age with nocturia in Germany, Sweden, and the UK, respectively. In an average year in each country, respectively, these patients were estimated to have 13.8, 1.4, and 10.0 million visits to a family practitioner or specialist, ~91,000, 9000, and 63,000 hospital admissions attributable to nocturia and 216,000, 19,000, and 130,000 subjects were estimated to incur a fracture resulting from nocturia. The annual direct cost of healthcare resource use attributable to managing nocturia was estimated to be approximately €2.32 billion in Germany, 5.11 billion kr (€0.54 billion) in Sweden, and £1.35 billion (€1.77 billion) in the UK. The annual indirect societal cost arising from both presenteeism and absenteeism was estimated to be approximately €20.76 billion in Germany and 19.65 billion kr (€2.10 billion) in Sweden. In addition, in the UK, the annual indirect cost due to absenteeism was an estimated £4.32 billion (€5.64 billion).ConclusionsNocturia appears to impose a substantial socioeconomic burden in all three countries. Clinical and economic benefits could accrue from an increased awareness of the impact that nocturia imposes on patients, health services, and society as a whole.

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If a patient was referred to a specialist, only one additional specialist visit was assumed.

Patients would initially visit their family practitioner in Sweden and the UK.

Patients who have a fall would visit an accident and emergency department; those with fractures would require some type of fracture-related procedure in a hospital.

…”

Section: Methodsmentioning

confidence: 99%

Annual direct and indirect costs attributable to nocturia in Germany, Sweden, and the UK

et al. 2016

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“…2 There is also an increased likelihood of falls among older people with nocturia, 26 which may arise directly from the necessity to make trips to the bathroom at night and/or sleepiness during the day. Studies have shown a significant positive association between the frequency of voiding each night and the prevalence of bone fractures, 26, 27 with two voids or more per night associated with a greater than 2-fold increase in the risk of fractures (hazard ratio [HR] 2.45, 95% CI 1.08, 5.54) and fall-related fractures (HR 2.63, 95% CI 1.05, 6.57) in one study. 26 A recent study also found the increased risk of hip fractures in men with nocturia to be age-independent.…”

Section: What Is the Real-life Burden Of ‘Disturbed Sleep’ And Nocturia?mentioning

confidence: 99%

The effect of nocturia on sleep

Ancoli‐Israel

Bliwise

Nørgaard

2011

Sleep Medicine Reviews

110

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Sleep plays a vital role in physical and mental functioning. It is increasingly recognized that disturbed sleep is a highly prevalent and chronic condition that merits greater awareness due to the wide-ranging and serious repercussions associated with it. Nocturia is one of the causes of sleep disturbance and has been shown to impair functioning, quality of life, health and productivity, with those experiencing two or more voids per night reporting significant ‘bother’. Nocturia warrants full consideration as a significant target for intervention, aiming to reduce the burden of disturbed sleep on individuals, families and society. Currently however, a definitive evaluation of the most relevant sleep endpoints in nocturia therapy is lacking. One endpoint often used is the duration of the initial sleep period, which when evaluated in combination with the number of voiding episodes per night might be an indication of the severity of sleep disruption in patients with nocturia.

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“…As nocturia is often caused by NP, patients may experience the consequences of a negative fluid balance at night, in the form of thirst – causing the patient to rise to get a drink – and/or giddiness when standing (38,39), both of which may lead to a further increased risk of falling at night. The finding of increased fracture rates in those with nocturia is supported by a recent population‐based survey of 788 elderly Japanese people (40). Incidents of falling not only cause direct distress and pain to the patient, but also place a considerable burden on the family or carer.…”

Section: The Clinical Impact Of Disrupted Sleepmentioning

confidence: 81%

Thinking beyond the bladder: antidiuretic treatment of nocturia

Kerrebroeck

Hashim

Holm-Larsen

et al. 2010

International Journal of Clinical Practice

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Nocturia is a bothersome and highly prevalent urological condition characterised by the need to wake to void at night. Contrary to popular misconception, nocturia is equally common in men and women, and although its prevalence increases with age, a significant proportion of younger people are also affected. Nocturia leads to repeated fragmentation of sleep and consequently to a serious decline in daytime functioning and in overall quality of life and health. As such, its impact should not be underestimated by clinicians. Traditionally, nocturia has been regarded as a symptom of benign prostatic enlargement and/or overactive bladder syndrome, with treatment therefore directed towards increasing the capacity of the bladder to hold urine. Such treatments have proven largely ineffective in many patients, likely because nocturnal polyuria (NP), a condition that results in overproduction of urine at night, has been found to be present in the majority of nocturia patients. As such, the traditional belief that nocturia is attributable to some other underlying pathological factors, is now being replaced by the acknowledgment that it can be a distinct clinical entity with specific pathogenesis. Frequency‐volume charts are an invaluable tool, recommended for routine use in clinical practice, to determine whether nocturia is a result of excessive urine production at night, or of small voided volumes (indicating bladder storage problems), or indeed a combination of these factors. Given the specific antidiuretic action of desmopressin, a synthetic analogue of the body’s own antidiuretic hormone, it should be considered as first‐line therapy for patients with nocturia where NP is present.

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Association Between Nocturia and Fractures in a Community-Dwelling Elderly Population Aged 70 Years and Over: Results of a 3-Year Prospective Cohort Study in Japan

Cited by 5 publications

References 0 publications

Annual direct and indirect costs attributable to nocturia in Germany, Sweden, and the UK

Annual direct and indirect costs attributable to nocturia in Germany, Sweden, and the UK

The effect of nocturia on sleep

Thinking beyond the bladder: antidiuretic treatment of nocturia

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