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Association between nocturia and frailty among elderly males in a veterans administration population

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A Correction to this article was published on 02 January 2020

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Abstract

Background

The relationship between frailty and nocturnal voiding is poorly understood.

Aim

To characterize the association between frailty, as defined by a frailty index (FI) based upon the Canadian Study of Health and Aging (CSHA) criteria, and nocturia, defined by measures of nocturnal urine production.

Methods

Real-world retrospective analysis of voiding diaries from elderly males with lower urinary tract symptoms (LUTS) at an outpatient urology clinic. Males ≥ 65 years with ≥ 2 nocturnal voids were included. A modified FI was calculated from the LUTS database, which captured 39 variables from the original CSHA FI. Patients were divided into 3 groups by modified FI: low (≤ 0.077) (n = 59), intermediate (> 0.077 and < 0.179) (n = 58), and high (≥ 0.179) (n = 41). Diary parameters were compared using the Kruskal–Wallis test and pairwise comparisons with the Wilcoxon rank-sum test and Bonferroni adjustment.

Results

The high frailty group was characterized by higher nocturnal urine volume (NUV), maximum voided volume (MVV), nocturnal maximum voided volume (NMVV), and nocturnal urine production (NUP). The presence of comorbid diabetes mellitus did not explain this effect.

Conclusion

Elderly males seeking treatment for LUTS with a high frailty burden are disproportionately affected by excess nocturnal urine production. Future research on the mechanistic relationship between urine production and functional impairment is warranted.

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Change history

  • 02 January 2020

    In the original publication of the article, the author’s name Jeffrey P. Weiss was misspelled as “Jeffry P. Weiss”.

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Funding

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Authors and Affiliations

  1. Department of Urology, State University of New York Downstate Health Sciences University, Brooklyn, NY, USA

    Thomas F. Monaghan, Christina W. Agudelo, Kyle P. Michelson, Syed N. Rahman, Matthew R. Epstein & Jeffrey P. Weiss

  2. Department of Medicine, University of Alberta, Edmonton, Canada

    Adrian S. Wagg

  3. Department of Neurology, Emory University School of Medicine, Atlanta, GA, USA

    Donald L. Bliwise

  4. Department of Urology, Temple University Hospital, Philadelphia, PA, USA

    Matthew R. Epstein

  5. Department of Urology, Ghent University Hospital, Ghent, Belgium

    Rebecca Haddad & Karel Everaert

  6. Sorbonne Université, UPMC Univ Paris 06, AP–HP GRC 01, Groupe de Recherche Clinique en Neuro-Urologie (GREEN), Service de Rééducation Neurologique, AP–HP, Hôpitaux Universitaires Est Parisien, Paris, France

    Rebecca Haddad

  7. Department of Medicine, Division of Cardiovascular Medicine, SUNY Downstate Health Sciences University, Brooklyn, NY, USA

    Jason M. Lazar

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  1. Thomas F. Monaghan
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Corresponding author

Correspondence to Thomas F. Monaghan.

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Conflict of interest

Thomas F. Monaghan has no direct or indirect commercial incentive associated with publishing this article and certifies that all conflicts of interest relevant to the subject matter discussed in the manuscript are the following: Adrian S. Wagg has received financial support from Astellas Pharma, Essity Health & Hygiene AB, Ferring, Pierre Fabre and Pfizer Corp outside the submitted work. Dr. Bliwise has served as a consultant for Merck, Jazz, Ferring, Eisai, and Respicardia and speaker for Merck within the last three years, outside the submitted work. Dr. Haddad reports grants from Fonds de dotation Renaitre and from Société Interdisciplinaire Francophone d’UroDynamique et de Pelvi Périnéologie, during the conduct of the study; personal fees and non-financial support from Astellas, personal fees from MedDay Pharmaceuticals and from Novartis Pharma SAS, non-financial support from Dentsply Sirona France, Pierre Fabre Medicament, Allergan France, Bayer HealthCare SAS and Vifor France SA, outside the submitted work. Karel Everaert is a consultant and lecturer for Medtronic and Ferring and reports institutional grants from Allergan, Ferring, Astellas, and Medtronic, outside the submitted work. Jeffrey Weiss is a consultant for Ferring, and the Institute for Bladder and Prostate Research, outside the submitted work. 5 additional authors have nothing to disclose.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. A nocturnal voiding database was compiled for retrospective analysis upon approval from the Veterans Affairs New York Harbor Healthcare System Institutional Review Board.

Informed consent

A waiver of informed consent was granted for retrospective analysis.

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The original version of this article was revised: The original publication of the article, the author’s name Jeffrey P. Weiss was misspelled as “Jeffry P. Weiss”.

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Monaghan, T.F., Wagg, A.S., Bliwise, D.L. et al. Association between nocturia and frailty among elderly males in a veterans administration population. Aging Clin Exp Res 32, 1993–2000 (2020). https://doi.org/10.1007/s40520-019-01416-y

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  • DOI: https://doi.org/10.1007/s40520-019-01416-y

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