Noctural Enuresis as a Risk Factor for Falls in Older Community Dwelling Women with Urinary Incontinence

Abstract

Purpose-To determine the association between urinary symptoms, fall risk and physical limitations in older community-dwelling women with urinary incontinence (UI).Materials and Methods-In-depth assessment of day and nighttime urinary symptoms, fall risk, physical function, physical performance tests and mental function in older communitydwelling women with UI and who had not sought care for their urinary symptoms. All assessments were performed in the participants' homes. We used univariable and multivariable linear regression to examine the relationship of urinary symptoms with fall risk, physical function, and physical performance.Results-In 37 women with UI (mean age 74 ± 8.4 years), 48% were at high risk for falls. Nocturnal enuresis was reported by 50%. Increased fall risk was associated with increasing frequency of nocturnal enuresis (p=0.04), worse lower limb (p<0.001) and worse upper limb (p<0.0001) function and worse performance on a composite physical performance test of strength, gait and balance (p=0.02). Women with nocturnal enuresis had significantly lower median physical performance test scores (7, range 0, 11) than women without nocturnal enuresis (median 9, range 1, 12, p=0.04). In a multivariable regression model that included age, nocturnal enuresis episodes and physical function, only physical function was associated with increased fall risk (p<0.0001).Conclusion-Nocturnal enuresis is common in older community-dwelling women with UI and may serve as a marker for fall risk even in women not seeking care for their urinary symptoms.

The association between lower urinary tract symptoms and falls: Forming a theoretical model for a research agenda

“…Neither severity of UI nor severity of nocturia was associated with an increased risk of falls, but there was a statistically significant association between nocturnal enuresis and impairment of physical function and the presence of frailty. However, in the multivariable regression model, which included age, physical function, and the frequency of nocturnal enuresis episodes, only physical function remained as significant risk factor for falls . One study, a prospective cohort study of older men in the United States of America, identified a statistically significant association between straining to void and falls, with a 60% increase in falls risk for those reporting the need to push or strain to initiate urination at least half the time …”

“…However, in the multivariable regression model, which included age, physical function, and the frequency of nocturnal enuresis episodes, only physical function remained as significant risk factor for falls. 26 One study, a prospective cohort study of older men in the United States of America, identified a statistically significant association between straining to void and falls, with a 60% increase in falls risk for those reporting the need to push or strain to initiate urination at least half the time. 27 The use of sedative medications has been identified as a potential risk factor for falls in those with LUTS.…”

Controle postural estático e risco de quedas em mulheres idosas com e sem incontinência urinária

“…When analyzing the occurrence of previous falls and the risk of falls, no significant difference was found when comparing the study groups. In the literature, the association between UI and falls in older people is well reported [7][8][9] . Possible causes involve extrinsic factors, such as the urgency to get to the bathroom at night 8 and intrinsic factors such as the weakening of PFMs 24 .…”

“…In the literature, the association between UI and falls in older people is well reported [7][8][9] . Possible causes involve extrinsic factors, such as the urgency to get to the bathroom at night 8 and intrinsic factors such as the weakening of PFMs 24 . However, falls are likely consequences of several factors besides UI 26 .…”

“…UI is considered a public health problem that negatively affects the individual's quality of life and social relations, generating high expenses with its treatment 2,4 . In addition, studies suggest that urinary loss is strongly associated with falls in older people [5][6][7][8] , and its incidence tends to increase with age 9 .…”