The Impact of Nocturia on Falls and Fractures: A Systematic Review and Meta-Analysis

Abstract

AEP)Purpose: Although nocturia is associated with various comorbidities, its impact on falls and fractures remains unclear. We performed a systematic review and meta-analysis to evaluate the association between nocturia and falls and fractures as a prognostic and as a causal risk factor. Materials and Methods: We searched PubMedÒ, ScopusÒ, CINAHL (Cumulative Index to Nursing and Allied Health Literature) and abstracts of major urological meetings up to December 31, 2018. We conducted random effects meta-analyses of adjusted relative risks of falls and fractures. We applied the GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach to rate the quality of evidence for nocturia as a prognostic and causal factor of falls and fractures. Results: Among 5,230 potential reports 9 observational longitudinal studies provided data on the association between nocturia and falls or fractures (1 for both, 4 for falls, 4 for fractures). Pooled estimates demonstrated a risk ratio of 1.20 (95% CI The corresponding author certifies that, when applicable, a statement(s) has been included in the manuscript documenting institutional review board, ethics committee or ethical review board study approval; principles of Helsinki Declaration were followed in lieu of formal ethics committee approval; institutional animal care and use committee approval; all human subjects provided written informed consent with guarantees of confidentiality; IRB approved protocol number; animal approved project number.

Nocturia through the menopausal transition and beyond: a narrative review

“…Nocturia, defined by the International Continence Society as the act of waking to pass urine during the mean sleeping period, is a common problem in older women [1] and associated with significant morbidity and impairments in health-related quality of life [1][2][3][4]. Nocturia has been identified as an independent risk factor for falls and hip fractures [5], shown to directly impair the normal sleep cycle [6] and is intricately related to the pathogenesis of a broad range of serious systemic diseases [7], such that it has been recognized as a significant prognostic factor for all-cause mortality [2]. Although nocturia is a pervasive complaint in patients of all backgrounds, age is consistently recognized to be among the most robust correlates of the presence and severity of nocturia [8], with the prevalence of nocturia of two or more voids per night increasing from approximately 18% in women in the fourth decade of life to upwards of 60% in women greater than 80 years of age [9,10].…”

Association of lower urinary tract symptoms and hip fracture in adults aged ≥ 50 years

“…Significant morbidity [12][13][14] and a potential increase in the risk of falls may be observed; however, a significant connection is to reported. A systematic review of 15 studies stated an overactive bladder (OAB), nocturia, and anticholinergic medications were associated with an increased risk of falls and fracture; however, this was not concurred by the Osteoporotic Fractures in Men (MrOS) prospective cohort study [15][16][17][18][19]. Sporadic studies in Asian countries have compared this association.…”

A Longitudinal Study of Bidirectional Relationships between Sleep Disorder and Frequency of Nocturia: Results from the Iwaki Health Promotion Project

“…Also, nocturia and sleep disorder have a close relationship due to frequent nocturnal awakening [10][11][12][13]. Both nocturia and poor sleep quality are related to unfavorable outcomes such as heart disease, diabetes, depression, falls, accidents, impaired cognition, and poor quality of life [14][15][16][17][18]. However, it is difficult to define the association of nocturia with sleep disorder because of the complex relationship [19].…”