Men with moderate symptoms have an 11% increased risk of falling one or more times within one year.


ORLANDO—Elderly men with moderate or severe lower urinary tract symptoms (LUTS) are at significantly greater risk for falls, and the risk dramatically increases as the symptoms worsen, data show.

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The diagnosis and awareness of LUTS as a risk factor should help caregivers and patients take the necessary precautions to prevent falls, according to researchers at the University of California in San Diego and Oregon Health Sciences University in Portland.


The researchers, who presented their findings here at the American Urological Association (AUA) annual meeting, examined risk factors for falls and osteoporotic fractures among community dwelling men aged 65 and older. All of the men were evaluated every six months for urinary symptoms using the AUA Symptom Index (AUA-SI) and for incident falls between 2001 and 2005.


Among the 5,872 eligible study participants, 3,188 men (54%) reported mild urinary symptoms at study entry. Another 2,301 (39%) reported moderate symptoms of LUTS and 383 (6.5%) reported severe symptoms.


Men with moderate LUTS had an 11% increased risk of falling one or more times within one year, the study showed. Men with severe symptoms had a 33% increased risk of falling within one year.  Moderate and severe symptoms were associated with a 21% and 63% increased risk of falling two or more times, respectively.


Individual symptoms most strongly associated with falling included urinary urgency, need to push or strain to initiate urination, nocturia, and urinary frequency. In this analysis, medications that treat LUTS did not alter the risk, according to investigators.


Potential for prevention

“It’s previously been shown that if you target known risk factors with preventive interventions, then you can decrease the risk of falls,” said lead investigator J. Kellogg Parsons, MD, MHS, assistant professor of surgery in the division of urology/urologic oncology.


“Urinary symptoms have never before been definitively identified as a risk factor for falls. Therefore, these data raise the possibility that diagnosis and treatment of urinary symptoms may potentially prevent falls.”

Urinary symptoms are common in men aged 65 years and older, and as the population ages this will become an even bigger concern, he noted. “Now there is information physicians can use to sit down with their patients and say, ‘Based on this study, you are at increased risk for a fall, and let’s talk about this,’” Dr. Parsons said.