Suskind Anne M, Quanstrom Kathryn, Zhao Shoujun, Bridge Mark, Walter Louise C, Neuhaus John, Finlayson Emily
Department of Urology, University of California, San Francisco, CA.
Department of Urology, University of California, San Francisco, CA.
Urology. 2017 Aug;106:26-31. doi: 10.1016/j.urology.2017.03.058. Epub 2017 May 11.
To understand the relationship between age, frailty, and overactive bladder (OAB).
This is a prospective study of individuals age ≥65 years presenting to an academic urology practice between December 2015 and July 2016. All patients had a Timed Up and Go Test (TUGT), a parsimonious measure of frailty, on intake, and were thereby categorized as fast (≤10 seconds), intermediate (11-14 seconds), and slow (≥15 seconds). The TUGT and other clinical data were abstracted from the electronic medical record using direct queries. Logistic regression was used to examine the relationship between frailty and the diagnosis of OAB, adjusting for age, gender, and race.
Our cohort included 201 individuals with and 1162 individuals without OAB. Individuals with OAB had slower TUGTs (13.7 ± 7.9 seconds) than their non-OAB counterparts (10.9 ± 5.2 seconds), P <.0001, with 32.3% and 11.0% of OAB and non-OAB individuals being categorized as slow, or frail. In multivariable analysis, slower TUGT was a significant predictor of OAB (adjusted odds ratio: 3.0; 95% confidence interval: 2.0-4.8). Age was not independently associated with this diagnosis (P values >.05 for each age group).
Patients with OAB are statistically significantly frailer than individuals seeking care for other non-oncologic urologic diagnoses. Frailty, when adjusted for age, race, and gender, is a statistically significant predictor of OAB. Furthermore, frailty should be considered when caring for older patients with OAB, and OAB should be assessed when caring for frail older patients.
了解年龄、衰弱与膀胱过度活动症(OAB)之间的关系。
这是一项对2015年12月至2016年7月期间到学术性泌尿外科就诊的年龄≥65岁个体进行的前瞻性研究。所有患者在就诊时均进行了计时起立行走测试(TUGT),这是一种对衰弱的简易测量方法,据此分为快速组(≤10秒)、中等组(11 - 14秒)和慢速组(≥15秒)。TUGT及其他临床数据通过直接查询从电子病历中提取。采用逻辑回归分析来研究衰弱与OAB诊断之间的关系,并对年龄、性别和种族进行校正。
我们的队列包括201例患有OAB的个体和1162例未患有OAB的个体。患有OAB的个体TUGT时间(13.7 ± 7.9秒)比未患OAB的个体(10.9 ± 5.2秒)更慢,P <.0001,OAB个体和非OAB个体中分别有32.3%和11.0%被归类为慢速组,即衰弱组。在多变量分析中,TUGT时间较慢是OAB的一个显著预测因素(校正比值比:3.0;95%置信区间:2.0 - 4.8)。年龄与该诊断无独立相关性(每个年龄组的P值>.05)。
统计学上,患有OAB的患者比因其他非肿瘤性泌尿外科诊断就诊的个体更衰弱。在对年龄、种族和性别进行校正后,衰弱是OAB的一个统计学显著预测因素。此外,在照料老年OAB患者时应考虑衰弱因素,而在照料衰弱老年患者时应评估OAB情况。