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. 2018 Nov;35(11):1831-1841.
doi: 10.1007/s12325-018-0796-8. Epub 2018 Sep 25.

The Association Between Overactive Bladder and Falls and Fractures: A Systematic Review

Shelagh M Szabo  1 , Katherine L Gooch  2 , David R Walker  2 , Karissa M Johnston  3 , Adrian S Wagg  4
Affiliations

The Association Between Overactive Bladder and Falls and Fractures: A Systematic Review

Shelagh M Szabo et al. Adv Ther. 2018 Nov.

Abstract

Introduction: Urinary symptoms are associated with an increased risk of falls, but few studies have focused on patients with overactive bladder (OAB). This study aimed to synthesize estimates of the risk of falls and fractures in patients with OAB.

Methods: Medline, EMBASE, the Cumulative Index to Nursing and Allied Health Literature, and Scopus were systematically searched for observational studies that focused on patients with OAB. When available, data from a non-OAB comparison sample were included. Double independent review and data extraction were performed. Falls and fractures data were summarized by unadjusted and adjusted risks, and percent attributable risk (PAR) of falls and fractures associated with OAB.

Results: Fifteen studies were included in the analyses. The proportion of patients with OAB experiencing at least one fall over a year ranged from 18.9% to 50.0%, and the proportion of patients with OAB experiencing recurrent or serious falls ranged from 10.2% to 56.0%. In studies that included a non-OAB comparison sample, a higher risk of falls was observed in patients with OAB compared to those without. A significantly increased (1.3- to 2.3-fold) adjusted OAB-associated risk of falls was reported, while unadjusted PARs for OAB associated falls ranged from 3.7% to 15.5%. Risk was higher among women and those 65 years of age or older. While analysis of fractures showed elevated point estimates, most studies were underpowered to detect a statistically significant difference between groups.

Conclusions: Evidence from the published literature clearly demonstrates the importance of OAB and its symptoms as risk factors for falls and fractures.

Funding: Astellas.

Keywords: Accidental falls; Fractures, bone; Overactive; Review; Urinary bladder; Urology.

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Conflict of interest statement

Shelagh M. Szabo is an employee of Broadstreet Health Economics and Outcomes Research (HEOR), a company contracted by Astellas to conduct this study. Karissa M. Johnston is an employee of Broadstreet Health Economics and Outcomes Research (HEOR), a company contracted by Astellas to conduct this study. Katherine L. Gooch was an employee of Astellas at the time of study completion. She is now an employee of Sarepta Therapeutics. David R. Walker is an employee of Astellas. Adrian S. Wagg acted as a consultant to Broadstreet HEOR.

Figures

Fig. 1
Fig. 1
PRISMA diagram for study inclusion
Fig. 2
Fig. 2
Unadjusted estimates of the risk of falls among those with OAB, according to mean age and the percentage male of the sample
Fig. 3
Fig. 3
Unadjusted estimates of the percent attributable risk of falls associated with OAB, by mean age and the percentage male of the sample
Fig. 4
Fig. 4
Adjusted estimates of the risk of falls or fractures among those with OAB. *Presented incidence rate ratios rather than odds ratios. **Presented hazard ratios rather than odds ratios
See this image and copyright information in PMC

Comment in

References

    1. Stewart RB, Moore MT, May FE, Marks RG, Hale WE. Nocturia: a risk factor for falls in the elderly. J Am Geriatr Soc. 1992;40(12):1217–20. 10.1111/j.1532-5415.1992.tb03645.x - DOI - PubMed
    1. Deandrea S, Lucenteforte E, Bravi F, Foschi R, La Vecchia C, Negri E. Risk factors for falls in community-dwelling older people: a systematic review and meta-analysis. Epidemiology. 2010;21(5):658–68. 10.1097/EDE.0b013e3181e89905 - DOI - PubMed
    1. Florence CS, Bergen G, Atherly A, Burns E, Stevens J, Drake C. Medical costs of fatal and nonfatal falls in older adults. J Am Geriatr Soc. 2018;66(4):693–8. 10.1111/jgs.15304 - DOI - PMC - PubMed
    1. Faulkner KA, Cauley JA, Studenski SA, et al. Lifestyle predicts falls independent of physical risk factors. Osteoporos Int. 2009;20(12):2025–34. 10.1007/s00198-009-0909-y - DOI - PMC - PubMed
    1. Wein AJ, Rovner ES. Definition and epidemiology of overactive bladder. Urology. 2002;60(5 Suppl 1):7–12 (discussion).10.1016/S0090-4295(02)01784-3 - DOI - PubMed

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