Department of Healthcare Epidemiology, Graduate School of Medicine and Public Health, Kyoto University, Kyoto, Japan.
BMJ Open. 2013 May 3;3(5):e002413. doi: 10.1136/bmjopen-2012-002413.
To examine the association between overactive bladder (OAB) symptom severity and falls and the contribution of OAB symptoms to falls in a community-dwelling population.
Cross-sectional study.
2 Japanese municipalities.
A total of 2505 residents aged over 40 years, who participated in health check-ups conducted in 2010. OAB symptom assessed via overactive bladder symptom score (OABSS) was divided into six categories based on distribution and Japanese clinical guidelines. Mobility problems and depressive symptoms were assessed via the Timed Up and Go test and the short form of the Center for Epidemiologic Studies Depression Scale, respectively.
Self-reported any fall and frequent fall (≥2) over the 1-month period. Independent contributions to any fall and frequent falls were assessed via logistic regression to generate population-attributable fractions (PAFs), assuming separate causal relationships between OAB symptoms, mobility problems and depressive symptoms and any or frequent falls.
Among the total 1350 participants (mean age: 68.3 years) analysed, any fall and frequent falls were reported by 12.7% and 4.4%, respectively. Compared with no OABSS score, moderate-to-severe OAB and mild OAB were associated with any fall (adjusted ORs 2.37 (95% CI 1.12 to 4.98) and 2.51 (95% CI 1.14 to 5.52), respectively). Moderate-to-severe OAB was also strongly associated with frequent falls (adjusted OR 6.90 (95% CI 1.50 to 31.6)). Adjusted PAFs of OAB symptoms were 40.7% (95% CI 0.7% to 64.6%) for any fall and 67.7% (95% CI -23.1% to 91.5%) for frequent falls. Further, these point estimates were similar to or larger than those of mobility problems and depressive symptoms.
An association does indeed exist between OAB symptom severity and falls, and OAB symptoms might be important contributors to falls among community-dwelling adults. Further longitudinal studies are warranted to examine whether or not OAB symptoms predict risk of future falls and fall-related injuries.
研究社区居民中膀胱过度活动症（OAB）症状严重程度与跌倒之间的关系，以及 OAB 症状对跌倒的影响。
横断面研究。
日本的两个市。
共有 2505 名年龄在 40 岁以上的居民参加了 2010 年的健康检查。OAB 症状通过膀胱过度活动症症状评分（OABSS）进行评估，根据分布和日本临床指南将其分为六个类别。通过计时起立行走测试和流行病学研究中心抑郁量表的简短形式评估移动问题和抑郁症状。
报告 1 个月内发生的任何跌倒和频繁跌倒（≥2 次）。通过逻辑回归评估对任何跌倒和频繁跌倒的独立贡献，假设 OAB 症状、移动问题和抑郁症状与任何或频繁跌倒之间存在单独的因果关系，从而生成人群归因分数（PAF）。
在分析的 1350 名参与者中（平均年龄：68.3 岁），报告有 12.7%发生了任何跌倒，4.4%报告了频繁跌倒。与没有 OABSS 评分相比，中重度 OAB 和轻度 OAB 与任何跌倒有关（调整后的 OR 分别为 2.37（95%CI 1.12 至 4.98）和 2.51（95%CI 1.14 至 5.52））。中重度 OAB 也与频繁跌倒密切相关（调整后的 OR 为 6.90（95%CI 1.50 至 31.6））。OAB 症状的调整后 PAF 为任何跌倒的 40.7%（95%CI 0.7%至 64.6%）和频繁跌倒的 67.7%（95%CI -23.1%至 91.5%）。此外，这些点估计值与移动问题和抑郁症状的估计值相似或更大。
OAB 症状严重程度与跌倒之间确实存在关联，并且 OAB 症状可能是社区居住的成年人跌倒的重要原因。需要进一步的纵向研究来检验 OAB 症状是否预测未来跌倒和与跌倒相关的伤害的风险。
