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Association between overactive bladder treatment and falls among older adults
Author(s) -
Jayadevappa Ravishankar,
Chhatre Sumedha,
Newman Diane K.,
Schwartz Jerome Sanford,
Wein Alan J.
Publication year - 2018
Publication title -
neurourology and urodynamics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.918
H-Index - 90
eISSN - 1520-6777
pISSN - 0733-2467
DOI - 10.1002/nau.23719
Subject(s) - medicine , overactive bladder , nocturia , odds ratio , logistic regression , retrospective cohort study , urinary incontinence , urination , population , urinary system , urology , alternative medicine , environmental health , pathology
Aims To analyze the risk of falls associated with Overactive bladder (OAB), and the effects of OAB treatment on falls among older adult Medicare fee‐for‐service enrollees. Methods Population based retrospective longitudinal cohort design study using 5% Medicare claims between 2006 and 2010. Patients with a diagnosis of OAB (ICD 9: 596.51); Urinary Incontinence (ICD 9: 788.3); Urinary incontinence, unspecified (ICD 9: 788.30); Urge incontinence (ICD 9: 788.31); Mixed incontinence (male, female) (ICD 9: 788.33); Urinary frequency (ICD 9: 788.41); Nocturia (ICD 9: 788.43); or Urgency of urination (ICD 9: 788.63) were identified and followed retrospectively for 2 years. Falls was the main outcome of the study. Using logistic regressions, we analyzed the association between OAB and falls; and the protective effect of OAB treatment on falls. Propensity score and instrumental variable were used to minimize bias. Results We identified 33 631 Medicare enrollees (mean age = 77.8 years, sd = 7.6) with OAB. Higher proportion of OAB patients had falls, compared to those without OAB (11% vs 7%, P < 0.001). Diagnosis of OAB was associated with higher odds of falls (OR = 1.59; 95% CI = 1.53, 1.65) compared to those without OAB. Fourteen percent of OAB patients received OAB treatment. Treatment for OAB was associated with lower odds of falls (OR = 0.88; 95% CI = 0.80, 0.98) compared to those OAB patients who were not treated. Conclusions Older adults with OAB experience increased risk of falls. Treatment for OAB may reduce this risk. These findings emphasize the need to effectively identify and treat OAB in older adults.