Department of Urology, University of California-San Francisco, San Francisco, California.
Department of Biostatistics and Epidemiology, University of California-San Francisco, San Francisco, California.
Neurourol Urodyn. 2020 Jun;39(5):1584-1591. doi: 10.1002/nau.24414. Epub 2020 Jun 1.
To explore the relationship between frailty, age, and detrusor overactivity (DO) in older adults presenting to an academic urology practice.
This study uses the University of California, San Francisco Geriatric Urology Database to examine all adults ages ≥65 years who underwent urodynamic testing from December 2015 to April 2019. All subjects had a timed up and go test (TUGT) as a measure of frailty and were categorized as fast (≤10 seconds), intermediate (11-14 seconds), or slow (≥15 seconds), corresponding to not frail, pre-frail, and frail, respectively. Urodynamic studies were reviewed for the presence of DO. Univariate and multivariate logistic regression were used to examine the relationship between frailty, age, and the presence of DO.
In total, 549 older adults underwent urodynamics during the study period, and 48.5% had a study that demonstrated DO. Individuals with DO tended to be older (18.4% vs 11.0% were ≥80 years; P = .01) and more frail (19.5% vs 13.4% with TUGT ≥5 seconds; P < .01). Multivariate regression demonstrated that DO was associated with both pre-frail and frail TUGT times (adjusted odds ratio [aOR], 2.1; 95% confidence interval [CI], 1.3-3.4; P < .01 for TUGT 11-14 seconds, and aOR, 2.1; 95% CI, 1.1-4.0; P = .02 for TUGT ≥15 seconds). Age was not found to be significantly associated with DO (P's > .05).
Frailty, not age, is associated with DO among older adults undergoing urodynamics. Further research on the role of frailty in the evaluation and management of older adults with DO is warranted to best serve the needs of this population.
探讨在到学术泌尿科就诊的老年患者中，虚弱、年龄与逼尿肌过度活动（DO）之间的关系。
本研究使用加利福尼亚大学旧金山老年泌尿科数据库，对 2015 年 12 月至 2019 年 4 月期间接受尿动力学检查的所有≥65 岁成年人进行了检查。所有受试者均进行计时起立行走测试（TUGT），以评估虚弱程度，并分为快速（≤10 秒）、中等（11-14 秒）和缓慢（≥15 秒）三组，分别对应于无虚弱、虚弱前期和虚弱。回顾尿动力学研究以确定 DO 的存在。采用单变量和多变量逻辑回归来检验虚弱、年龄与 DO 存在之间的关系。
共有 549 名老年人在研究期间接受了尿动力学检查，其中 48.5%的检查显示存在 DO。患有 DO 的患者年龄较大（18.4%≥80 岁，11.0%；P=0.01），且更虚弱（19.5% TUGT 测试时间≥5 秒，13.4%；P<0.01）。多变量回归显示，DO 与虚弱前期和虚弱 TUGT 时间均相关（调整后的优势比 [aOR]，2.1；95%置信区间 [CI]，1.3-3.4；P<0.01，TUGT 为 11-14 秒，aOR，2.1；95%CI，1.1-4.0；P=0.02，TUGT 测试时间≥15 秒）。年龄与 DO 无显著相关性（P 值均>0.05）。
在接受尿动力学检查的老年患者中，与 DO 相关的是虚弱，而不是年龄。需要进一步研究虚弱在评估和管理 DO 老年患者中的作用，以满足这部分人群的需求。
