Urinary Incontinences Are Related with Fall and Fragility Fractures in Elderly Population: Nationwide Cohort Study
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Background: This prospective cohort study used nationwide claims data to investigate the incidence of fall and fragility fractures in association with urinary incontinence (UI) in the elderly, and to compare mortality after fragility fractures in elderly patients with or without incontinence. Methods: A total of 39,854 Korean adults (age, 66-80 years) who participated in health examinations between 2007 and 2012 and were followed up until 2015 were analyzed. Patient and comparison groups were classified according to the presence or absence of UI. The cumulative incidence of osteoporotic fragility fractures and falls in the 2 groups was assessed and compared. Hazard ratios for fragility fractures were calculated for the risk of UI in association with falls using a Cox proportional hazards model. Results: Of 39,854 elderly participants, 5,703 were classified in the UI group, while 34,151 were placed in the comparison group. Fall rates were significantly higher (20.8%) in the incontinence group than in the comparison group (4.7%) (P<0.001). Women in the incontinence group (13.9%) showed a significantly higher incidence of all types of fragility fractures than those in the comparison group (11.8%) (P=0.005). After adjustment for confounders, UI was not a significant risk factor for fragility fractures in men (P=0.878) or women (P=0.324). Conclusions: This study demonstrated that elderly women with UI have a significantly higher incidence of osteoporotic fragility fractures. In addition, elderly women are at higher risk for falls.
Abstract
Background: This prospective cohort study used nationwide claims data to investigate the incidence of fall and fragility fractures in association with urinary incontinence (UI) in the elderly, and to compare mortality after fragility fractures in elderly patients with or without incontinence. Methods: A total of 39,854 Korean adults (age, 66-80 years) who participated in health examinations between 2007 and 2012 and were followed up until 2015 were analyzed. Patient and comparison groups were classified according to the presence or absence of UI. The cumulative incidence of osteoporotic fragility fractures and falls in the 2 groups was assessed and compared. Hazard ratios for fragility fractures were calculated for the risk of UI in association with falls using a Cox proportional hazards model. Results: Of 39,854 elderly participants, 5,703 were classified in the UI group, while 34,151 were placed in the comparison group. Fall rates were significantly higher (20.8%) in the incontinence group than in the comparison group (4.7%) (P<0.001). Women in the incontinence group (13.9%) showed a significantly higher incidence of all types of fragility fractures than those in the comparison group (11.8%) (P=0.005). After adjustment for confounders, UI was not a significant risk factor for fragility fractures in men (P=0.878) or women (P=0.324). Conclusions: This study demonstrated that elderly women with UI have a significantly higher incidence of osteoporotic fragility fractures. In addition, elderly women are at higher risk for falls.
참고문헌 (22)
- Chiarelli PE, "Urinary incontinence is associated with an increase in falls: a systematic review", Aust J Physiother, 55, pp.89~95 (2009)
- Brown JS, "Urinary incontinence: does it increase risk for falls and fractures? Study of Osteoporotic Fractures Research Group", J Am Geriatr Soc, 48, pp.721~725 (2000)
- Schluter PJ, "Falls and hip fractures associated with urinary incontinence among older men and women with complex needs: a national population study", Neurourol Urodyn, 37, pp.1336~1343 (2018)
- Hasegawa J, "Urinary incontinence and behavioral symptoms are independent risk factors for recurrent and injurious falls, respectively, among residents in long-term care facilities", Arch Gerontol Geriatr, 50, pp.77~81 (2010)
- Frost M, "Risk factors for fracture in elderly men: a population-based prospective study", Osteoporos Int, 23, pp.521~531 (2012)
- Tinetti ME, "Risk factors for falls among elderly persons living in the community", N Engl J Med, 319, pp.1701~1707 (1988)
- Gosch M, "Urinary incontinence and poor functional status in fragility fracture patients: an underrecognized and underappreciated association", Arch Orthop Trauma Surg, 135, pp.59~67 (2015)
- Kang HY, "Incidence and mortality of hip fracture among the elderly population in South Korea: a population-based study using the national health insurance claims data", BMC Public Health, 10, pp.230~ (2010)
- 김하영, "Healthcare Costs of Osteoporotic Fracture in Korea: Information from the National Health Insurance Claims Database, 2008-2011", 대한골대사학회지, 24(2), pp.125~133 (2017), 대한골대사학회[DOI]
- Leung F, "Bavonratanavech S. Surgery for fragility hip fracture-streamlining the process", Osteoporos Int, 21, pp.S519~S521 (2010)
- Wagner TH, "Health-related consequences of overactive bladder", Am J Manag Care, 8, pp.S598~S607 (2002)
- Takazawa K, "Relationship between the type of urinary incontinence and falls among frail elderly women in Japan", J Med Invest, 52, pp.165~171 (2005)
- 박찬호, "Change of Bone Mineral Density Measurement among Patients with Osteoporotic Fractures in Korean Population Using National Claim Database", 대한골대사학회지, 24(3), pp.183~186 (2017), 대한골대사학회[DOI]
- 김현수, "National Screening Program for Transitional Ages in Korea:A New Screening for Strengthening Primary Prevention and Follow-up Care", Journal of Korean Medical Science, 27, pp.70~75 (2012), 대한의학회[DOI]
- 양동원, "Korean Dementia Screeing Questionnaire (KDSQ)의 개발과 타당도 및 신뢰도의 평가", 대한신경과학회지, 20(2), pp.135~141 (2002), 대한신경과학회
- "New generation proficiency testing program" (2018)[URL]
- Palmer MH, "Risk factors for hospital-acquired incontinence in elderly female hip fracture patients", J Gerontol A Biol Sci Med Sci, 57, pp.M672~M677 (2002)
- Teo JS, "Do sleep problems or urinary incontinence predict falls in elderly women?", Aust J Physiother, 52, pp.19~24 (2006)
- O'Loughlin JL, "Incidence of and risk factors for falls and injurious falls among the community-dwelling elderly", Am J Epidemiol, 137, pp.342~354 (1993)
- Johansson C, "Urinary incontinence: a minor risk factor for hip fractures in elderly women", Maturitas, 25, pp.21~28 (1996)
- Kiely DK, "Identifying nursing home residents at risk for falling", J Am Geriatr Soc, 46, pp.551~555 (1998)
- Kron M, "Risk indicators for falls in institutionalized frail elderly", Am J Epidemiol, 158, pp.645~653 (2003)