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老年人下尿路症状与功能能力:基于社区的横断面研究。

Lower urinary tract symptoms and functional ability in older adults: a community-based cross-sectional study.

机构信息

Institute of Gerontology, The University of Tokyo, Bunkyo-ku, Japan

Department of Public Health, School of Medicine, Dokkyo Medical University, Shimotsuga-gun, Japan.

出版信息

BMJ Open. 2022 Apr 25;12(4):e054530. doi: 10.1136/bmjopen-2021-054530.

Abstract

OBJECTIVES

Functional ability, or the ability to live actively in older age, is essential for healthy ageing. This study assessed the association between the five types of lower urinary tract symptoms (LUTS) and functional ability among community-dwelling older adults (≥65 years old).

DESIGN

A cross-sectional study.

SETTING

Community-dwelling older adults (≥65 years old) randomly selected from the basic resident register of Kashiwa city as part of the Kashiwa study.

PARTICIPANTS

The study included 916 community-dwelling older adults (481 male participants) in Japan.

OUTCOME MEASURES

A self-administered questionnaire was used to collect data regarding LUTS, which included frequency, nocturia, urgency, urinary incontinence and overactive bladder (OAB). Functional ability was measured using the Japan Science and Technology Agency Index of Competence. Sex-stratified logistic regression analyses were conducted, adjusting age, obesity, alcohol consumption, polypharmacy and comorbidities.

RESULTS

Male participants experienced symptoms of frequency, nocturia, urgency, urinary incontinence and OAB at rates of 68.0%, 89.0%, 16.0%, 3.7% and 4.3%, respectively. Female participants experienced these symptoms at rates of 68.3%, 80.0%, 11.0%, 7.4% and 8.5%, respectively. Among male participants, lower functional ability was only associated with nocturia (≥3 times/night) (adjusted OR (AOR): 1.71, 95% CI 1.05 to 2.79). Contrarily, lower functional ability among female participants was significantly associated with frequency (AOR: 1.61, 95% CI 1.04 to 2.49), urgency (AOR: 2.06, 95% CI 1.08 to 3.95) and OAB (AOR: 2.43, 95% CI 1.15 to 5.11).

CONCLUSION

The different associations between LUTS and functional ability by sex might be related to differences in the effect of comorbidities and physical fatigue. Our results help clarify the multifaceted effects of LUTS in old age, the need for early detection and treatment of LUTS, and the importance of maintaining functional ability.

摘要

目的

功能能力,或老年人积极生活的能力,对健康老龄化至关重要。本研究评估了五种下尿路症状(LUTS)类型与社区居住的老年人(≥65 岁)功能能力之间的关联。

设计

横断面研究。

地点

日本柏市基本居民登记处随机抽取的社区居住老年人(≥65 岁)作为柏市研究的一部分。

参与者

研究包括日本 916 名社区居住的老年人(481 名男性参与者)。

结果测量

使用自我管理问卷收集 LUTS 数据,包括频率、夜尿、尿急、尿失禁和膀胱过度活动症(OAB)。使用日本科学技术厅能力指数测量功能能力。进行了按性别分层的逻辑回归分析,调整了年龄、肥胖、饮酒、多药治疗和合并症。

结果

男性参与者出现频率、夜尿、尿急、尿失禁和 OAB 症状的比例分别为 68.0%、89.0%、16.0%、3.7%和 4.3%。女性参与者出现这些症状的比例分别为 68.3%、80.0%、11.0%、7.4%和 8.5%。在男性参与者中,较低的功能能力仅与夜尿(≥3 次/夜)相关(调整后的比值比(AOR):1.71,95%置信区间 1.05 至 2.79)。相反,女性参与者较低的功能能力与频率(AOR:1.61,95%置信区间 1.04 至 2.49)、尿急(AOR:2.06,95%置信区间 1.08 至 3.95)和 OAB(AOR:2.43,95%置信区间 1.15 至 5.11)显著相关。

结论

不同性别下尿路症状与功能能力之间的关联可能与合并症和身体疲劳的影响差异有关。我们的研究结果有助于阐明下尿路症状在老年人群中的多方面影响,需要早期检测和治疗下尿路症状,以及保持功能能力的重要性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2247/9039374/f1faf1679ecc/bmjopen-2021-054530f01.jpg

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