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Overactive Bladder in Frail Older Adults.
Christina Shaw1,2, Adrian Wagg3
1Division of Geriatric Medicine, Department of Medicine, University of Alberta, 1-198 Clinical Sciences Bldg, 11350 83 Ave, Edmonton, AB, T6G 2P4, Canada.
Drugs & Aging
|June 20, 2020
Summary
Overactive bladder (OAB) and frailty are common in older adults. Urinary urgency might precede frailty, and OAB treatments, including medications, are safe and effective for frail individuals.
Area of Science:
- Gerontology
- Urology
- Geriatric Medicine
Background:
- Overactive bladder (OAB) and frailty are prevalent, age-related syndromes.
- A direct link between OAB and frailty is not well-established, but urinary urgency may precede frailty.
- Frail older adults require treatment, with lifestyle, behavioral, and pharmacological options available.
Purpose of the Study:
- To explore the association between OAB and frailty in older adults.
- To review the efficacy and safety of OAB treatments in frail populations.
- To advocate for the inclusion of frail older adults in OAB treatment trials.
Main Methods:
- Literature review of existing evidence on OAB and frailty.
- Analysis of treatment options for OAB in older adults, focusing on frail individuals.
- Examination of data regarding specific OAB therapies in frail populations.
Main Results:
- Antimuscarinics and beta-adrenergic agonists show safety, tolerability, and efficacy in older adults, including those with frailty.
- Data on onabotulinumtoxinA and percutaneous tibial nerve stimulation in frail individuals are limited.
- Cognitive impairment should not preclude the use of antimuscarinics.
Conclusions:
- Further research is needed to understand the OAB-frailty association and its impact on outcomes.
- OAB treatments, particularly medications, are viable for frail older adults.
- Clinical trials for OAB therapies must include frail older adults due to their high prevalence and exclusion from current studies.
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