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Longitudinal Associations between Concurrent Changes in Phenotypic Frailty and Lower Urinary Tract Symptoms among
S R Bauer1, C E McCulloch, P M Cawthon
1Scott R. Bauer, SFVA Medical Center, Division of General Internal Medicine 4150 Clement St., Building 2, Room 135, San Francisco, CA 94121, USA, Email: Scott.Bauer@ucsf.edu, Phone: 415-221-4810 x24322, Twitter handle: @ScottBauerMD, Publicly available data: https://mrosonline.ucsf.edu.
The Journal of Frailty & Aging
|March 22, 2023
Summary
In older men, increasing frailty over time is linked to worsening lower urinary tract symptoms (LUTS). This suggests a shared underlying mechanism not addressed by current LUTS treatments.
Area of Science:
- Gerontology
- Urology
- Public Health
Background:
- Lower urinary tract symptoms (LUTS) are common in older adults and linked to frailty.
- Longitudinal data on the relationship between frailty progression and LUTS is limited.
Purpose of the Study:
- To investigate the association between changes in phenotypic frailty and concurrent increases in LUTS severity.
- To examine this relationship in older men without significant LUTS at the study's start.
Main Methods:
- A multicenter, prospective, population-based cohort study of community-dwelling men aged 65+.
- Phenotypic frailty was assessed over 7 years using an adapted Fried criterion (0-5 score).
- LUTS severity was measured by the American Urologic Association Symptom Index (AUASI), excluding men with AUASI ≥8 at baseline.
Main Results:
- Among 3235 men, increasing frailty was non-linearly associated with greater LUTS severity (quadratic P<0.001).
- Baseline frailty status did not predict LUTS change, but within-person increases in frailty correlated with worsening AUASI.
- Men with 5 frailty criteria showed significantly higher predicted AUASI compared to those with 0 criteria.
Conclusions:
- Phenotypic frailty progression is independently associated with increasing LUTS severity in older men.
- The findings suggest a shared underlying mechanism between LUTS and frailty.
- Current LUTS interventions may not target this shared pathway.
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