Frailty burden and symptomatic BPH/LUTS in aging men: evidence from two nationally representative population-based...

Area of Science:

• Gerontology
• Urology
• Public Health

Background:

• The frailty index (FI) is a key indicator of biological aging and predicts adverse health outcomes in older adults.
• The relationship between FI and symptomatic benign prostatic hyperplasia/lower urinary tract symptoms (BPH/LUTS) is not well-established in national populations.

Purpose of the Study:

• To investigate the association between frailty index levels and symptomatic BPH/LUTS in men.
• Utilize data from two large, population-based studies to examine this relationship.

Main Methods:

• Analysis of men from the China Health and Retirement Longitudinal Study (CHARLS) and US National Health and Nutrition Examination Survey (NHANES).
• Construction of cohort-specific FIs using the Rockwood-Mitnitski deficit-accumulation approach.
• Operationalization of symptomatic BPH/LUTS using questionnaires and medication data; analysis via multivariable logistic regression and restricted cubic splines.

Main Results:

• Higher log(FI) was significantly associated with increased odds of BPH/LUTS in both CHARLS (OR 1.91) and NHANES (OR 1.47) after adjustment.
• Frailty index tertiles demonstrated graded associations with BPH/LUTS, with higher tertiles showing increased prevalence (e.g., CHARLS Q3 vs Q1 OR 2.91).
• Effect modification by drinking, age, and smoking status was noted; machine learning models showed good internal discrimination.

Conclusions:

• Elevated frailty index levels are associated with a higher prevalence of broadly defined symptomatic BPH/LUTS in nationally representative male populations.
• The current cross-sectional design indicates association, not causation; longitudinal studies are required to confirm temporal relationships between frailty and BPH/LUTS.